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Sample records for geneva consensus recommendations

  1. Is There a Consensus on Consensus Methodology? Descriptions and Recommendations for Future Consensus Research.

    PubMed

    Waggoner, Jane; Carline, Jan D; Durning, Steven J

    2016-05-01

    The authors of this article reviewed the methodology of three common consensus methods: nominal group process, consensus development panels, and the Delphi technique. The authors set out to determine how a majority of researchers are conducting these studies, how they are analyzing results, and subsequently the manner in which they are reporting their findings. The authors conclude with a set of guidelines and suggestions designed to aid researchers who choose to use the consensus methodology in their work.Overall, researchers need to describe their inclusion criteria. In addition to this, on the basis of the current literature the authors found that a panel size of 5 to 11 members was most beneficial across all consensus methods described. Lastly, the authors agreed that the statistical analyses done in consensus method studies should be as rigorous as possible and that the predetermined definition of consensus must be included in the ultimate manuscript. More specific recommendations are given for each of the three consensus methods described in the article.

  2. Managing Carious Lesions: Consensus Recommendations on Terminology.

    PubMed

    Innes, N P T; Frencken, J E; Bjørndal, L; Maltz, M; Manton, D J; Ricketts, D; Van Landuyt, K; Banerjee, A; Campus, G; Doméjean, S; Fontana, M; Leal, S; Lo, E; Machiulskiene, V; Schulte, A; Splieth, C; Zandona, A; Schwendicke, F

    2016-05-01

    Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current words used in the literature for caries removal techniques, and 2) agreed terms and definitions, explaining how these were decided.Dental cariesis the name of the disease, and thecarious lesionis the consequence and manifestation of the disease-the signs or symptoms of the disease. The termdental caries managementshould be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereascarious lesion managementcontrols the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions' clinical manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1)selective removal of carious tissue-includingselective removal to soft dentineandselective removal to firm dentine; 2)stepwise removal-including stage 1,selective removal to soft dentine, and stage 2,selective removal to firm dentine6 to 12 mo later; and 3)nonselective removal to hard dentine-formerly known ascomplete caries removal(technique no longer recommended). Adoption of these terms, around managing dental caries and its sequelae, will facilitate improved understanding and communication among researchers and within dental educators and the wider clinical dentistry community.

  3. Globular glial tauopathies (GGT): consensus recommendations.

    PubMed

    Ahmed, Zeshan; Bigio, Eileen H; Budka, Herbert; Dickson, Dennis W; Ferrer, Isidro; Ghetti, Bernardino; Giaccone, Giorgio; Hatanpaa, Kimmo J; Holton, Janice L; Josephs, Keith A; Powers, James; Spina, Salvatore; Takahashi, Hitoshi; White, Charles L; Revesz, Tamas; Kovacs, Gabor G

    2013-10-01

    Recent studies have highlighted a group of 4-repeat (4R) tauopathies that are characterised neuropathologically by widespread, globular glial inclusions (GGIs). Tau immunohistochemistry reveals 4R immunoreactive globular oligodendroglial and astrocytic inclusions and the latter are predominantly negative for Gallyas silver staining. These cases are associated with a range of clinical presentations, which correlate with the severity and distribution of underlying tau pathology and neurodegeneration. Their heterogeneous clinicopathological features combined with their rarity and under-recognition have led to cases characterised by GGIs being described in the literature using various and redundant terminologies. In this report, a group of neuropathologists form a consensus on the terminology and classification of cases with GGIs. After studying microscopic images from previously reported cases with suspected GGIs (n = 22), this panel of neuropathologists with extensive experience in the diagnosis of neurodegenerative diseases and a documented record of previous experience with at least one case with GGIs, agreed that (1) GGIs were present in all the cases reviewed; (2) the morphology of globular astrocytic inclusions was different to tufted astrocytes and finally that (3) the cases represented a number of different neuropathological subtypes. They also agreed that the different morphological subtypes are likely to be part of a spectrum of a distinct disease entity, for which they recommend that the overarching term globular glial tauopathy (GGT) should be used. Type I cases typically present with frontotemporal dementia, which correlates with the fronto-temporal distribution of pathology. Type II cases are characterised by pyramidal features reflecting motor cortex involvement and corticospinal tract degeneration. Type III cases can present with a combination of frontotemporal dementia and motor neuron disease with fronto-temporal cortex, motor cortex and

  4. Globular glial tauopathies (GGT): consensus recommendations

    PubMed Central

    Bigio, Eileen H.; Budka, Herbert; Dickson, Dennis W.; Ferrer, Isidro; Ghetti, Bernardino; Giaccone, Giorgio; Hatanpaa, Kimmo J.; Holton, Janice L.; Josephs, Keith A.; Powers, James; Spina, Salvatore; Takahashi, Hitoshi; White, Charles L.; Revesz, Tamas

    2014-01-01

    Rrecent studies have highlighted a group of 4-repeat (4R) tauopathies that are characterised neuropathologically by widespread, globular glial inclusions (GGIs). Tau immunohistochemistry reveals 4R immunore-active globular oligodendroglial and astrocytic inclusions and the latter are predominantly negative for Gallyas silver staining. These cases are associated with a range of clinical presentations, which correlate with the severity and distribution of underlying tau pathology and neurodegeneration. Their heterogeneous clinicopathological features combined with their rarity and under-recognition have led to cases characterised by GGIs being described in the literature using various and redundant terminologies. In this report, a group of neuropathologists form a consensus on the terminology and classification of cases with GGIs. After studying microscopic images from previously reported cases with suspected GGIs (n = 22), this panel of neuropathologists with extensive experience in the diagnosis of neurodegenerative diseases and a documented record of previous experience with at least one case with GGIs, agreed that (1) GGIs were present in all the cases reviewed; (2) the morphology of globular astrocytic inclusions was different to tufted astrocytes and finally that (3) the cases represented a number of different neuropathological subtypes. They also agreed that the different morphological subtypes are likely to be part of a spectrum of a distinct disease entity, for which they recommend that the overarching term globular glial tauopathy (GGT) should be used. Type I cases typically present with frontotemporal dementia, which correlates with the fronto-temporal distribution of pathology. Type II cases are characterised by pyramidal features reflecting motor cortex involvement and corticospinal tract degeneration. Type III cases can present with a combination of frontotemporal dementia and motor neuron disease with fronto-temporal cortex, motor cortex and

  5. Consensus-based recommendations for the management of juvenile dermatomyositis

    PubMed Central

    Enders, Felicitas Bellutti; Bader-Meunier, Brigitte; Baildam, Eileen; Constantin, Tamas; Dolezalova, Pavla; Feldman, Brian M; Lahdenne, Pekka; Magnusson, Bo; Nistala, Kiran; Ozen, Seza; Pilkington, Clarissa; Ravelli, Angelo; Russo, Ricardo; Uziel, Yosef; van Brussel, Marco; van der Net, Janjaap; Vastert, Sebastiaan; Wedderburn, Lucy R; Wulffraat, Nicolaas; McCann, Liza J; van Royen-Kerkhof, Annet

    2017-01-01

    Background In 2012, a European initiative called Single Hub and Access point for pediatric Rheumatology in Europe (SHARE) was launched to optimise and disseminate diagnostic and management regimens in Europe for children and young adults with rheumatic diseases. Juvenile dermatomyositis (JDM) is a rare disease within the group of paediatric rheumatic diseases (PRDs) and can lead to significant morbidity. Evidence-based guidelines are sparse and management is mostly based on physicians' experience. Consequently, treatment regimens differ throughout Europe. Objectives To provide recommendations for diagnosis and treatment of JDM. Methods Recommendations were developed by an evidence-informed consensus process using the European League Against Rheumatism standard operating procedures. A committee was constituted, consisting of 19 experienced paediatric rheumatologists and 2 experts in paediatric exercise physiology and physical therapy, mainly from Europe. Recommendations derived from a validated systematic literature review were evaluated by an online survey and subsequently discussed at two consensus meetings using nominal group technique. Recommendations were accepted if >80% agreement was reached. Results In total, 7 overarching principles, 33 recommendations on diagnosis and 19 recommendations on therapy were accepted with >80% agreement among experts. Topics covered include assessment of skin, muscle and major organ involvement and suggested treatment pathways. Conclusions The SHARE initiative aims to identify best practices for treatment of patients suffering from PRD. Within this remit, recommendations for the diagnosis and treatment of JDM have been formulated by an evidence-informed consensus process to produce a standard of care for patients with JDM throughout Europe. PMID:27515057

  6. Nurses' Perceptions of Consensus Reports Containing Recommendations for Practice.

    ERIC Educational Resources Information Center

    Fitzgerald, Sheila T.; Hill, Martha N.; Santamaria, Barbara; Howard, Cheryl; Jadack, Rose

    1997-01-01

    Responses from 1,107 nurses working with asthma patients showed positive to neutral views of consensus reports with practice recommendations from professional associations, government, and health agencies. Most felt the reports were a better source of information than colleagues, textbooks, or journals. However, 75% were unaware of one major set…

  7. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets

    PubMed Central

    Munns, Craig F.; Shaw, Nick; Kiely, Mairead; Specker, Bonny L.; Thacher, Tom D.; Ozono, Keiichi; Michigami, Toshimi; Tiosano, Dov; Mughal, M. Zulf; Mäkitie, Outi; Ramos-Abad, Lorna; Ward, Leanne; DiMeglio, Linda A.; Atapattu, Navoda; Cassinelli, Hamilton; Braegger, Christian; Pettifor, John M.; Seth, Anju; Idris, Hafsatu Wasagu; Bhatia, Vijayalakshmi; Fu, Junfen; Goldberg, Gail; Sävendahl, Lars; Khadgawat, Rajesh; Pludowski, Pawel; Maddock, Jane; Hyppönen, Elina; Oduwole, Abiola; Frew, Emma; Aguiar, Magda; Tulchinsky, Ted; Butler, Gary

    2016-01-01

    Background: Vitamin D and calcium deficiencies are common worldwide, causing nutritional rickets and osteomalacia, which have a major impact on health, growth, and development of infants, children, and adolescents; the consequences can be lethal or can last into adulthood. The goals of this evidence-based consensus document are to provide health care professionals with guidance for prevention, diagnosis, and management of nutritional rickets and to provide policy makers with a framework to work toward its eradication. Evidence: A systematic literature search examining the definition, diagnosis, treatment, and prevention of nutritional rickets in children was conducted. Evidence-based recommendations were developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system that describe the strength of the recommendation and the quality of supporting evidence. Process: Thirty-three nominated experts in pediatric endocrinology, pediatrics, nutrition, epidemiology, public health, and health economics evaluated the evidence on specific questions within five working groups. The consensus group, representing 11 international scientific organizations, participated in a multiday conference in May 2014 to reach a global evidence-based consensus. Results: This consensus document defines nutritional rickets and its diagnostic criteria and describes the clinical management of rickets and osteomalacia. Risk factors, particularly in mothers and infants, are ranked, and specific prevention recommendations including food fortification and supplementation are offered for both the clinical and public health contexts. Conclusion: Rickets, osteomalacia, and vitamin D and calcium deficiencies are preventable global public health problems in infants, children, and adolescents. Implementation of international rickets prevention programs, including supplementation and food fortification, is urgently required. PMID:26745253

  8. Recommendations for intra-abdominal infections consensus report

    PubMed Central

    Avkan-Oğuz, Vildan; Baykam, Nurcan; Sökmen, Selman; Güner, Rahmet; Agalar, Fatih; Alp, Emine; Doğrul, Ahmet; Turhan, Özge; Ağalar, Canan; Kurtaran, Behice; Geçim, İbrahim Ethem; Özaras, Reşat; Yılmaz, Gürdal; Akbulut, Ayhan; Koksal, İftihar

    2016-01-01

    Guidelines include the recommendations of experts from various specialties within a topic in consideration of data specific to each country. However, to date there has not been a guideline standardizing the nomenclature and offering recommendations for intra-abdominal infections (IAIs) in Turkey. This is mainly due to the paucity of laboratory studies regarding the clinical diagnosis and treatment of IAIs or the sensitivity of microorganisms isolated from patients with IAIs. However, due to the diversification of host characteristics and advancements in technological treatment methods, it has become imperative to ‘speak a common language’. For this purpose May 2015, a group of 15 experts in intra-abdominal infections, under the leadership of the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey (EKMUD) and with representatives from the Turkish Surgical Association, Turkish Society of Colon and Rectal Surgery, Hernia Society, Turkish Society of Hepato-pancreato-biliary Surgery, and the Turkish Society of Hospital Infections and Control, was formed to analyze relevant studies in the literature. Ultimately, the suggestions for adults found in this consensus report were developed using available data from Turkey, referring predominantly to the 2010 guidelines for diagnosing and managing complicated IAIs in adults and children by the Infectious Diseases Society of America (IDSA) and the Surgical Infection Society. The recommendations are presented in two sections, from the initial diagnostic evaluation of patients to the treatment approach for IAI. This Consensus Report was presented at the EKMUD 2016 Congress in Antalya and was subsequently opened for suggestions on the official websites of the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey and Turkish Surgical Association for one month. The manuscript was revised according to the feedback received. PMID:28149134

  9. Physiotherapy for functional motor disorders: a consensus recommendation

    PubMed Central

    Nielsen, Glenn; Stone, Jon; Matthews, Audrey; Brown, Melanie; Sparkes, Chris; Farmer, Ross; Masterton, Lindsay; Duncan, Linsey; Winters, Alisa; Daniell, Laura; Lumsden, Carrie; Carson, Alan; David, Anthony S; Edwards, Mark

    2015-01-01

    Background Patients with functional motor disorder (FMD) including weakness and paralysis are commonly referred to physiotherapists. There is growing evidence that physiotherapy is an effective treatment, but the existing literature has limited explanations of what physiotherapy should consist of and there are insufficient data to produce evidence-based guidelines. We aim to address this issue by presenting recommendations for physiotherapy treatment. Methods A meeting was held between physiotherapists, neurologists and neuropsychiatrists, all with extensive experience in treating FMD. A set of consensus recommendations were produced based on existing evidence and experience. Results We recommend that physiotherapy treatment is based on a biopsychosocial aetiological framework. Treatment should address illness beliefs, self-directed attention and abnormal habitual movement patterns through a process of education, movement retraining and self-management strategies within a positive and non-judgemental context. We provide specific examples of these strategies for different symptoms. Conclusions Physiotherapy has a key role in the multidisciplinary management of patients with FMD. There appear to be specific physiotherapy techniques which are useful in FMD and which are amenable to and require prospective evaluation. The processes involved in referral, treatment and discharge from physiotherapy should be considered carefully as a part of a treatment package. PMID:25433033

  10. Melanoma: diagnosis, staging, and treatment. Consensus group recommendations.

    PubMed

    Berrocal, Alfonso; Cabañas, Luis; Espinosa, Enrique; Fernández-de-Misa, Ricardo; Martín-Algarra, Salvador; Martínez-Cedres, José Carlos; Ríos-Buceta, Luis; Rodríguez-Peralto, José Luis

    2014-09-01

    The incidence of malignant melanoma is increasing worldwide. In Spain, its incidence is increasing faster than any other cancer type, with a 5-year survival rate of about 85%. The impact and characteristics of malignant melanoma in the Spanish population can be ascertained from the national melanoma registry of the Academia Española de Dermatología y Venereología. This review presents consensus group recommendations for the diagnosis, staging and treatment of malignant melanoma in Spain. Incidence and mortality are discussed, as well as evaluation of various prevention and treatment strategies. Prognostic factors, such as BRAF and C-KIT mutations, which are expected to become routine staging procedures over the next few years, are outlined, especially in relation to treatment options. The use of recently approved targeted agents such as ipilimumab, a cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) inhibitor, and vemurafenib, a BRAF inhibitor, in metastatic disease are also discussed.

  11. CONSENSUS TREATMENT RECOMMENDATIONS FOR LATE-ONSET POMPE DISEASE

    PubMed Central

    Cupler, Edward J.; Berger, Kenneth I.; Leshner, Robert T.; Wolfe, Gil I.; Han, Jay J.; Barohn, Richard J.; Kissel, John T.

    2012-01-01

    Introduction Pompe disease is a rare, autosomal recessive disorder caused by deficiency of the glycogen-degrading lysosomal enzyme acid alpha-glucosidase. Late-onset Pompe disease is a multisystem condition, with a heterogeneous clinical presentation that mimics other neuromuscular disorders. Methods Objective is to propose consensus-based treatment and management recommendations for late-onset Pompe disease. Methods A systematic review of the literature by a panel of specialists with expertise in Pompe disease was undertaken. Conclusions A multidisciplinary team should be involved to properly treat the pulmonary, neuromuscular, orthopedic, and gastrointestinal elements of late-onset Pompe disease. Presymptomatic patients with subtle objective signs of Pompe disease (and patients symptomatic at diagnosis) should begin treatment with enzyme replacement therapy (ERT) immediately; presymptomatic patients without symptoms or signs should be observed without use of ERT. After 1 year of ERT, patients’ condition should be reevaluated to determine whether ERT should be continued. PMID:22173792

  12. Recommendations for the management of biofilm: a consensus document.

    PubMed

    Bianchi, T; Wolcott, R D; Peghetti, A; Leaper, D; Cutting, K; Polignano, R; Rosa Rita, Z; Moscatelli, A; Greco, A; Romanelli, M; Pancani, S; Bellingeri, A; Ruggeri, V; Postacchini, L; Tedesco, S; Manfredi, L; Camerlingo, Maria; Rowan, S; Gabrielli, A; Pomponio, G

    2016-06-01

    The potential impact of biofilm on healing in acute and chronic wounds is one of the most controversial current issues in wound care. A significant amount of laboratory-based research has been carried out on this topic, however, in 2013 the European Wound Management Association (EWMA) pointed out the lack of guidance for managing biofilms in clinical practice and solicited the need for guidelines and further clinical research. In response to this challenge, the Italian Nursing Wound Healing Society (AISLeC) initiated a project which aimed to achieve consensus among a multidisciplinary and multiprofessional international panel of experts to identify what could be considered part of 'good clinical practice' with respect to the recognition and management of biofilms in acute and chronic wounds. The group followed a systematic approach, developed by the GRADE working group, to define relevant questions and clinical recommendations raised in clinical practice. An independent librarian retrieved and screened approximately 2000 pertinent published papers to produce tables of levels of evidence. After a smaller focus group had a multistep structured discussion, and a formal voting process had been completed, ten therapeutic interventions were identified as being strongly recommendable for clinical practice, while another four recommendations were graded as being 'weak'. The panel subsequently formulated a preliminary statement (although with a weak grade of agreement): 'provided that other causes that prevent optimal wound healing have been ruled out, chronic wounds are chronically infected'. All members of the panel agreed that there is a paucity of reliable, well-conducted clinical trials which have produced clear evidence related to the effects of biofilm presence. In the meantime it was agreed that expert-based guidelines were needed to be developed for the recognition and management of biofilms in wounds and for the best design of future clinical trials. This is a

  13. Multicentre consensus recommendations for skin care in inherited epidermolysis bullosa

    PubMed Central

    2014-01-01

    Background Inherited epidermolysis bullosa (EB) comprises a highly heterogeneous group of rare diseases characterized by fragility and blistering of skin and mucous membranes. Clinical features combined with immunofluorescence antigen mapping and/or electron microscopy examination of a skin biopsy allow to define the EB type and subtype. Molecular diagnosis is nowadays feasible in all EB subtypes and required for prenatal diagnosis. The extent of skin and mucosal lesions varies greatly depending on EB subtype and patient age. In the more severe EB subtypes lifelong generalized blistering, chronic ulcerations and scarring sequelae lead to multiorgan involvement, major morbidity and life-threatening complications. In the absence of a cure, patient management remains based on preventive measures, together with symptomatic treatment of cutaneous and extracutaneous manifestations and complications. The rarity and complexity of EB challenge its appropriate care. Thus, the aim of the present study has been to generate multicentre, multidisciplinary recommendations on global skin care addressed to physicians, nurses and other health professionals dealing with EB, both in centres of expertise and primary care setting. Methods Almost no controlled trials for EB treatment have been performed to date. For this reason, recommendations were prepared by a multidisciplinary team of experts from different European EB centres based on available literature and expert opinion. They have been subsequently revised by a panel of external experts, using an online-modified Delphi method to generate consensus. Results Recommendations are reported according to the age of the patients. The major topics treated comprise the multidisciplinary approach to EB patients, global skin care including wound care, management of itching and pain, and early diagnosis of squamous cell carcinoma. Aspects of therapeutic patient education, care of disease burden and continuity of care are also developed

  14. Consensus Recommendations on Training and Competing in the Heat.

    PubMed

    Racinais, Sébastien; Alonso, Juan-Manuel; Coutts, Aaron J; Flouris, Andreas D; Girard, Olivier; González-Alonso, José; Hausswirth, Christophe; Jay, Ollie; Lee, Jason K W; Mitchell, Nigel; Nassis, George P; Nybo, Lars; Pluim, Babette M; Roelands, Bart; Sawka, Michael N; Wingo, Jonathan; Périard, Julien D

    2015-07-01

    Exercising in the heat induces thermoregulatory and other physiological strain that can lead to impairments in endurance exercise capacity. The purpose of this consensus statement is to provide up-to-date recommendations to optimize performance during sporting activities undertaken in hot ambient conditions. The most important intervention one can adopt to reduce physiological strain and optimize performance is to heat acclimatize. Heat acclimatization should comprise repeated exercise-heat exposures over 1-2 weeks. In addition, athletes should initiate competition and training in an euhydrated state and minimize dehydration during exercise. Following the development of commercial cooling systems (e.g., cooling vests), athletes can implement cooling strategies to facilitate heat loss or increase heat storage capacity before training or competing in the heat. Moreover, event organizers should plan for large shaded areas, along with cooling and rehydration facilities, and schedule events in accordance with minimizing the health risks of athletes, especially in mass participation events and during the first hot days of the year. Following the recent examples of the 2008 Olympics and the 2014 FIFA World Cup, sport governing bodies should consider allowing additional (or longer) recovery periods between and during events for hydration and body cooling opportunities when competitions are held in the heat.

  15. Consensus recommendations on training and competing in the heat

    PubMed Central

    Racinais, S; Alonso, J M; Coutts, A J; Flouris, A D; Girard, O; González-Alonso, J; Hausswirth, C; Jay, O; Lee, J K W; Mitchell, N; Nassis, G P; Nybo, L; Pluim, B M; Roelands, B; Sawka, M N; Wingo, J; Périard, J D

    2015-01-01

    Exercising in the heat induces thermoregulatory and other physiological strain that can lead to impairments in endurance exercise capacity. The purpose of this consensus statement is to provide up-to-date recommendations to optimise performance during sporting activities undertaken in hot ambient conditions. The most important intervention one can adopt to reduce physiological strain and optimise performance is to heat acclimatise. Heat acclimatisation should comprise repeated exercise-heat exposures over 1–2 weeks. In addition, athletes should initiate competition and training in a euhydrated state and minimise dehydration during exercise. Following the development of commercial cooling systems (eg, cooling-vest), athletes can implement cooling strategies to facilitate heat loss or increase heat storage capacity before training or competing in the heat. Moreover, event organisers should plan for large shaded areas, along with cooling and rehydration facilities, and schedule events in accordance with minimising the health risks of athletes, especially in mass participation events and during the first hot days of the year. Following the recent examples of the 2008 Olympics and the 2014 FIFA World Cup, sport governing bodies should consider allowing additional (or longer) recovery periods between and during events, for hydration and body cooling opportunities, when competitions are held in the heat. PMID:26069301

  16. Consensus recommendations on training and competing in the heat.

    PubMed

    Racinais, S; Alonso, J M; Coutts, A J; Flouris, A D; Girard, O; González-Alonso, J; Hausswirth, C; Jay, O; Lee, J K W; Mitchell, N; Nassis, G P; Nybo, L; Pluim, B M; Roelands, B; Sawka, M N; Wingo, J; Périard, J D

    2015-09-01

    Exercising in the heat induces thermoregulatory and other physiological strain that can lead to impairments in endurance exercise capacity. The purpose of this consensus statement is to provide up-to-date recommendations to optimise performance during sporting activities undertaken in hot ambient conditions. The most important intervention one can adopt to reduce physiological strain and optimise performance is to heat acclimatise. Heat acclimatisation should comprise repeated exercise-heat exposures over 1-2 weeks. In addition, athletes should initiate competition and training in a euhydrated state and minimise dehydration during exercise. Following the development of commercial cooling systems (eg, cooling-vest), athletes can implement cooling strategies to facilitate heat loss or increase heat storage capacity before training or competing in the heat. Moreover, event organisers should plan for large shaded areas, along with cooling and rehydration facilities, and schedule events in accordance with minimising the health risks of athletes, especially in mass participation events and during the first hot days of the year. Following the recent examples of the 2008 Olympics and the 2014 FIFA World Cup, sport governing bodies should consider allowing additional (or longer) recovery periods between and during events, for hydration and body cooling opportunities, when competitions are held in the heat.

  17. Consensus recommendations on training and competing in the heat.

    PubMed

    Racinais, S; Alonso, J M; Coutts, A J; Flouris, A D; Girard, O; González-Alonso, J; Hausswirth, C; Jay, O; Lee, J K W; Mitchell, N; Nassis, G P; Nybo, L; Pluim, B M; Roelands, B; Sawka, M N; Wingo, J E; Périard, J D

    2015-06-01

    Exercising in the heat induces thermoregulatory and other physiological strain that can lead to impairments in endurance exercise capacity. The purpose of this consensus statement is to provide up-to-date recommendations to optimize performance during sporting activities undertaken in hot ambient conditions. The most important intervention one can adopt to reduce physiological strain and optimize performance is to heat acclimatize. Heat acclimatization should comprise repeated exercise-heat exposures over 1-2 weeks. In addition, athletes should initiate competition and training in a euhydrated state and minimize dehydration during exercise. Following the development of commercial cooling systems (e.g., cooling vest), athletes can implement cooling strategies to facilitate heat loss or increase heat storage capacity before training or competing in the heat. Moreover, event organizers should plan for large shaded areas, along with cooling and rehydration facilities, and schedule events in accordance with minimizing the health risks of athletes, especially in mass participation events and during the first hot days of the year. Following the recent examples of the 2008 Olympics and the 2014 FIFA World Cup, sport governing bodies should consider allowing additional (or longer) recovery periods between and during events for hydration and body cooling opportunities when competitions are held in the heat.

  18. [Consensus conference on acute bronchiolitis (I): methodology and recommendations].

    PubMed

    González de Dios, J; Ochoa Sangrador, C

    2010-03-01

    The recommendations of the Consensus Conference "Diagnostic and Therapeutic Management of Acute Bronchiolitis" are presented. Evidence on the frequency of bronchiolitis in the general population and risk groups, risk factors and markers of severe forms, severity scores and the clinical-etiological profile is summarized. The commonly used diagnostic tests are ineffective in the management of the disease; oxygen saturation measurement is considered necessary only in the initial assessment or to monitor changes in patients with respiratory distress. Other tests such as chest radiograph, rapid diagnostic tests for respiratory virus infection and screening tests for bacterial infection should be used only very selectively. There is sufficient evidence on the lack of effectiveness of most interventions tested in bronchiolitis. Apart from oxygen therapy, fluid therapy, aspiration of secretions and ventilation support, few treatment options will be beneficial. Only in moderate-severe bronchiolitis would it be justified to test a treatment with inhaled bronchodilators (salbutamol or epinephrine) with or without hypertonic saline solution. Heliox and non-invasive ventilation techniques could be used in cases with respiratory failure, methylxanthine in patients with apnea and surfactant in intubated critically ill patients. No treatment has proved effective in preventing persistence or recurrence of post-bronchiolitis symptoms. As for prevention of bronchiolitis, only palivizumab slightly reduces the risk of admissions for lower respiratory infections by respiratory syncytial virus, although its high cost justifies its use only in a small group of high-risk patients.

  19. First International Consensus Report on Adnexal Masses: Management Recommendations.

    PubMed

    Glanc, Phyllis; Benacerraf, Beryl; Bourne, Tom; Brown, Douglas; Coleman, Beverly G; Crum, Christopher; Dodge, Jason; Levine, Deborah; Pavlik, Edward; Timmerman, Dirk; Ueland, Frederick R; Wolfman, Wendy; Goldstein, Steven R

    2017-03-07

    The First International Consensus Conference on Adnexal Masses was convened to thoroughly examine the state of the science and to formulate recommendations for clinical assessment and management. The panel included representatives of societies in the fields of gynecology, gynecologic oncology, radiology, and pathology and clinicians from Europe, Canada, and the United States. In the United States, there are approximately 9.1 surgeries per malignancy compared to the European International Ovarian Tumor Analysis center trials, with only 2.3 (oncology centers) and 5.9 (other centers) reported surgeries per malignancy, suggesting that there is room to improve our preoperative assessments. The American College of Obstetricians and Gynecologists Practice Bulletin on "Management of Adnexal Masses," reaffirmed in 2015 (Obstet Gynecol 2007; 110:201-214), still states, "With the exception of simple cysts on a transvaginal ultrasound finding, most pelvic masses in postmenopausal women will require surgical intervention." The panel concluded that patients would benefit not only from a more conservative approach to many benign adnexal masses but also from optimization of physician referral patterns to a gynecologic oncologist in cases of suspected ovarian malignancies. A number of next-step options were offered to aid in management of cases with sonographically indeterminate adnexal masses. This process would provide an opportunity to improve risk stratification for indeterminate masses via the provision of alternatives, including but not limited to evidence-based risk-assessment algorithms and referral to an "expert sonologist" or to a gynecologic oncologist. The panel believed that these efforts to improve clinical management and preoperative triage patterns would ultimately improve patient care.

  20. Multidisciplinary consensus on the therapeutic recommendations for iatrogenic hyperprolactinemia secondary to antipsychotics.

    PubMed

    Montejo, Ángel L; Arango, Celso; Bernardo, Miquel; Carrasco, José L; Crespo-Facorro, Benidicto; Cruz, Juan J; Del Pino-Montes, Javier; García-Escudero, Miguel A; García-Rizo, Clemente; González-Pinto, Ana; Hernández, Ana I; Martín-Carrasco, Manuel; Mayoral-Cleries, Fermín; Mayoral-van Son, Jaqueline; Mories, M Teresa; Pachiarotti, Isabella; Pérez, Jesús; Ros, Salvador; Vieta, Eduard

    2017-04-01

    Hyperprolactinemia is an underappreciated/unknown adverse effects of antipsychotics. The consequences of hyperprolactinemia compromise therapeutic adherence and can be serious. We present the consensus recommendations made by a group of experts regarding the management of antipsychotic-induced hyperprolactinemia. The current consensus was developed in 3 phases: 1, review of the scientific literature; 2, subsequent round table discussion to attempt to reach a consensus among the experts; and 3, review by all of the authors of the final conclusions until reaching a complete consensus. We include recommendations on the appropriate time to act after hyperprolactinemia detection and discuss the evidence on available options: decreasing the dose of the antipsychotic drug, switching antipsychotics, adding aripiprazole, adding dopaminergic agonists, and other type of treatment. The consensus also included recommendations for some specific populations such as patients with a first psychotic episode and the pediatric-youth population, bipolar disorder, personality disorders and the elderly population.

  1. Toward a sustainable biomedical research enterprise: Finding consensus and implementing recommendations.

    PubMed

    Pickett, Christopher L; Corb, Benjamin W; Matthews, C Robert; Sundquist, Wesley I; Berg, Jeremy M

    2015-09-01

    The US research enterprise is under significant strain due to stagnant funding, an expanding workforce, and complex regulations that increase costs and slow the pace of research. In response, a number of groups have analyzed the problems and offered recommendations for resolving these issues. However, many of these recommendations lacked follow-up implementation, allowing the damage of stagnant funding and outdated policies to persist. Here, we analyze nine reports published since the beginning of 2012 and consolidate over 250 suggestions into eight consensus recommendations made by the majority of the reports. We then propose how to implement these consensus recommendations, and we identify critical issues, such as improving workforce diversity and stakeholder interactions, on which the community has yet to achieve consensus.

  2. Recommendations for the Clinical Management of Hepatitis C in Iran: A Consensus-Based National Guideline

    PubMed Central

    Alavian, Seyed Moayed; Hajarizadeh, Behzad; Bagheri Lankarani, Kamran; Sharafi, Heidar; Ebrahimi Daryani, Nasser; Merat, Shahin; Mohraz, Minoo; Mardani, Masoud; Fattahi, Mohamad Reza; Poustchi, Hossein; Nikbin, Mehri; Nabavi, Mahmood; Adibi, Peyman; Ziaee, Masood; Behnava, Bita; Rezaee-Zavareh, Mohammad Saeid; Colombo, Massimo; Massoumi, Hatef; Bizri, Abdul Rahman; Eghtesad, Bijan; Amiri, Majid; Namvar, Ali; Hesamizadeh, Khashayar; Malekzadeh, Reza

    2016-01-01

    Context Hepatitis C virus (HCV) infection is a major public health issue worldwide, including Iran. The new direct-acting antiviral agents (DAAs) with high efficacy have changed the landscape of HCV treatment. This guideline provides updated recommendations for clinical management of HCV infection in Iran. Evidence Acquisition The recommendations of this guideline are based on international and national scientific evidences and consensus-based expert opinion. Scientific evidences were collected through a systematic review of studies that evaluated efficacy and safety of DAA regimens, using PubMed, Scopus and Web of Science. Expert opinion was based on the consensus of Iran Hepatitis Scientific Board (IHSB) in the 3rd national consensus on management of Hepatitis C in Iran, held on 22nd of July 2016. Results Pegylated Interferon alpha (PegIFN), Ribavirin (RBV), Sofosbuvir (SOF), Ledipasvir (LDV) and Daclatasvir (DCV) are currently available in Iran. Pre-treatment assessments include HCV RNA level, HCV genotype and resistance testing, assessment of liver fibrosis, and underlying diseases. In HCV genotype 1 and 4, DCV/SOF and LDV/SOF are recommended. In HCV genotype 2, SOF plus RBV and in HCV genotype 3, DCV/SOF is recommended. Additional care for underlying diseases should be considered. Conclusions Affordable new HCV treatment regimens are available in Iran, providing an opportunity for HCV elimination. Recommendations provided in this current national guideline can facilitate evidence-based management of HCV infection. PMID:27799966

  3. Gender-specific Issues in Traumatic Injury and Resuscitation: Consensus-based Recommendations for Future Research

    PubMed Central

    Sethuraman, Kinjal N.; Marcolini, Evie G.; McCunn, Maureen; Hansoti, Bhakti; Vaca, Federico E.; Napolitano, Lena M.

    2015-01-01

    Traumatic injury remains an unacceptably high contributor to morbidity and mortality rates across the United States. Gender-specific research in trauma and emergency resuscitation has become a rising priority. In concert with the 2014 Academic Emergency Medicine consensus conference “Gender-specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes,” a consensus-building group consisting of experts in emergency medicine, critical care, traumatology, anesthesiology, and public health convened to generate research recommendations and priority questions to be answered and thus move the field forward. Nominal group technique was used for the consensus-building process and a combination of face-to-face meetings, monthly conference calls, e-mail discussions, and preconference surveys were used to refine the research questions. The resulting research agenda focuses on opportunities to improve patient outcomes by expanding research in sex- and gender-specific emergency care in the field of traumatic injury and resuscitation. PMID:25420732

  4. [Renal tumors: The International Society of Urologic Pathology (ISUP) 2012 consensus conference recommendations].

    PubMed

    Rioux-Leclercq, Nathalie; Ferran, Algaba; Mahul, Amin; Argani, Pedram; Billis, Athanase; Bonsib, Stephen; Cheng, Liang; Cheville, John; Eble, John; Egevad, Lars; Epstein, Jonathan; Grignon, David; Hes, Ondrej; Humphrey, Peter; Magi-Galluzzi, Cristina; Martignoni, Guido; McKenney, Jesse; Merino, Maria; Moch, Holger; Montironi, Rodolfo; Netto, George; Reuter, Viktor; Samaratunga, Hemamali; Shen, Steven; Srigley, John; Tamboli, Pheroze; Tan, Puay Hoon; Tickoo, Satish; Trpkov, Kiril; Zhou, Ming; Delahunt, Brett; Comperat, Eva

    2014-12-01

    During the last 30 years many advances have been made in kidney tumor pathology. In 1981, 9 entities were recognized in the WHO Classification. In the latest classification of 2004, 50 different types have been recognized. Additional tumor entities have been described since and a wide variety of prognostic parameters have been investigated with variable success; however, much attention has centered upon the importance of features relating to both stage and grade. The International Society of Urological Pathology (ISUP) recommends after consensus conferences the development of reporting guidelines, which have been adopted worldwide ISUP undertook to review all aspects of the pathology of adult renal malignancy through an international consensus conference to be held in 2012. As in the past, participation in this consensus conference was restricted to acknowledged experts in the field.

  5. The World Health Organization Guidelines on Hand Hygiene in Health Care and their consensus recommendations.

    PubMed

    Pittet, Didier; Allegranzi, Benedetta; Boyce, John

    2009-07-01

    The World Health Organization's Guidelines on Hand Hygiene in Health Care have been issued by WHO Patient Safety on 5 May 2009 on the occasion of the launch of the Save Lives: Clean Your Hands initiative. The Guidelines represent the contribution of more than 100 international experts and provide a comprehensive overview of essential aspects of hand hygiene in health care, evidence- and consensus-based recommendations, and lessons learned from testing their Advanced Draft and related implementation tools.

  6. Clinical challenges in patients with cancer-associated thrombosis: Canadian expert consensus recommendations

    PubMed Central

    Carrier, M.; Lazo–Langner, A.; Shivakumar, S.; Tagalakis, V.; Gross, P.L.; Blais, N.; Butts, C.A.; Crowther, M.

    2015-01-01

    Venous thromboembolism is a common complication in cancer patients, and thromboembolism is the second most common cause of death after cancer progression. A number of clinical practice guidelines provide recommendations for the management of cancer-associated thrombosis. However, the guidelines lack recommendations covering commonly encountered clinical challenges (for example, thrombocytopenia, recurrent venous thromboembolism, etc.) for which little or no evidence exists. Accordingly, recommendations were developed to provide expert guidance to medical oncologists and other health care professionals caring for patients with cancer-associated thrombosis. The current expert consensus was developed by a team of 21 clinical experts. For each identified clinical challenge, the literature in medline, embase, and Evidence Based Medicine Reviews was systematically reviewed. The quality of the evidence was assessed, summarized, and graded. Consensus statements were generated, and the experts voted anonymously using a modified Delphi process on their level of agreement with the various statements. Statements were progressively revised through separate voting iterations and were then finalized. Clinicians using these recommendations and suggestions should tailor patient management according to the risks and benefits of the treatment options, patient values and preferences, and local cost and resource allocations. PMID:25684988

  7. Diagnosis and management of Neuro-Behçet's disease: international consensus recommendations.

    PubMed

    Kalra, Seema; Silman, Alan; Akman-Demir, Gulsen; Bohlega, Saeed; Borhani-Haghighi, Afshin; Constantinescu, Cris S; Houman, Habib; Mahr, Alfred; Salvarani, Carlos; Sfikakis, Petros P; Siva, Aksel; Al-Araji, Adnan

    2014-09-01

    Neuro-Behçet's disease (NBD) is one of the more serious manifestations of Behçet's disease (BD), which is a relapsing inflammatory multisystem disease with an interesting epidemiology. Though NBD is relatively uncommon, being potentially treatable, neurologists need to consider it in the differential diagnosis of inflammatory, infective, or demyelinating CNS disorders. Evidence-based information on key issues of NBD diagnosis and management is scarce, and planning for such studies is challenging. We therefore initiated this project to develop expert consensus recommendations that might be helpful to neurologists and other clinicians, created through an extensive literature review and wide consultations with an international advisory panel, followed by a Delphi exercise. We agreed on consensus criteria for the diagnosis of NBD with two levels of certainty in addition to recommendations on when to consider NBD in a neurological patient, and on the use of various paraclinical tests. The management recommendations included treatment of the parenchymal NBD and cerebral venous thrombosis, the use of disease modifying therapies, prognostic factors, outcome measures, and headache in BD. Future studies are needed to validate the proposed criteria and provide evidence-based treatments.

  8. Erythrocytosis in children and adolescents-classification, characterization, and consensus recommendations for the diagnostic approach.

    PubMed

    Cario, Holger; McMullin, Mary Frances; Bento, Celeste; Pospisilova, Dagmar; Percy, Melanie J; Hussein, Kais; Schwarz, Jiri; Aström, Maria; Hermouet, Sylvie

    2013-11-01

    During recent years, the increasing knowledge of genetic and physiological changes in polycythemia vera (PV) and of different types of congenital erythrocytosis has led to fundamental changes in recommendations for the diagnostic approach to patients with erythrocytosis. Although widely accepted for adult patients this approach may not be appropriate with regard to children and adolescents affected by erythrocytosis. The "congenital erythrocytosis" working group established within the framework of the MPN&MPNr-EuroNet (COST action BM0902) addressed this question in a consensus finding process and developed a specific algorithm for the diagnosis of erythrocytosis in childhood and adolescence which is presented here.

  9. [The BCTRIMS Expanded Consensus on treatment of multiple sclerosis: III. Evidence and recommendation-based guidelines].

    PubMed

    Lana-Peixoto, Marco Aurélio; Callegaro, Dagoberto; Moreira, Marcos Aurélio; Campos, Gilberto Belisário; Marchiori, Paulo Eurípedes; Gabbai, Alberto Alain; Bacheschi, Luiz Alberto; Arruda, Walter Oleschko; Gama, Paulo Diniz; Melo, Aílton Souza; Rocha, Fernando Coronetti Gomes; Lino, Angelina Maria Martins; Ferreira, Maria Lúcia Brito; Ataide, Luiz

    2002-09-01

    There has been unprecedented advances in knowledge of multiple sclerosis (MS) in the last few years. A new set of criteria for its diagnosis and a bunch of recent clinical trials with disease-modifying agents (DMA) have been published. All of that has made it necessary to update and expand the previous consensus for MS treatment as formulated by the Brazilian Committee for Treatment and Research in Multiple Sclerosis (BCTRIMS) two years ago. The BCTRIMS Expanded Consensus emphasizes the need to (1) consider MS treatment on an individual basis; (2) educate patients about the potential benefits and risks of treatment; (3) monitor drugs side effects; (4) have a signed Informed Consent Form; (5) consider the relative cost of the drug. The various clinical possibilities and the indications of the DMA and other immunointerventions are considered according to classes of evidences and types of recommendations. The BCTRIMS Expanded Consensus on Treatment of MS may turn out to be a model to other developing countries.

  10. Consensus-based recommendations for case report in Chinese medicine (CARC).

    PubMed

    Fu, Shu-Fei; Cheng, Chung-Wah; Zhang, Li; Zhong, Linda Li-Dan; Kun, Wai; Lin, Jia; Zhang, Bo-Li; Wang, Yong-Yan; Shang, Hong-Cai; Bian, Zhao-Xiang

    2016-01-01

    Case reports are valuable clinical evidence in traditional Chinese medicine (TCM). However, the general reporting quality is suboptimal. A working group comprising 20 members was set up to develop systematic recommendations on case report in Chinese medicine (CARC). The working group (CARC group) developed a primary checklist based on reviewing the general reporting quality of case reports in TCM and thorough internal discussion. Two-round consensus process had been carried out among clinical experts, evidence-based medicine methodologists, medical journal editors and clinical practitioners with designated questionnaire embedded with the primary checklist. In total, 118 participants from 17 provinces of China and Korea completed the questionnaires. Their feedback was analyzed and discussed by the CARC group. The checklist was amended accordingly, and the final version, comprising 16-item, is presented here. Under the framework of CARC recommendations, the reporting quality of case reports in TCM can be improved.

  11. [Formalized consensus: clinical practice recommendations for the management of the migraine in African adult patients].

    PubMed

    Ahmed, Mahmoud Ait Kaci; Haddad, Monia; Kouassi, Beugré; Ouhabi, Hamid; Serrie, Alain

    2016-01-01

    Migraine is a primary headache disorder (according to the latest International Headache Society criteria) affecting approximately 8% of African population. Women are more often affected than men and attacks usually occur before the age of 40 years Although some treatments, hygienic-dietary measures and other non-pharmacological methods can reduce the intensity and frequency of attacks, medicinal treatment of migraine attack is often necessary. Availability of treatments and access to care differ in Africa and led to the implementation of the first expert consensus recommendations for the management of the migraine in african adult patients. This multinational collaborative study is intended for health practitioners. It aims to provide 16 simple, evidence-based recommendations and is adapted to african medical practice.

  12. Mentoring during surgical training: consensus recommendations for mentoring programmes from the Association of Surgeons in Training.

    PubMed

    Sinclair, P; Fitzgerald, J E F; McDermott, F D; Derbyshire, L; Shalhoub, J

    2014-11-01

    Mentoring has been present within surgical training for many years, albeit in different forms. There is evidence that formal mentoring can improve patient outcomes and facilitate learning and personal growth in the mentee. The Association of Surgeons in Training (ASiT) is an independent educational charity working to promote excellence in surgical training. This document recommends the introduction of a structured mentoring programme, which is readily accessible to all surgical trainees. A review of the available evidence--including an ASiT-led survey of its membership--highlights the desire of surgical trainees to have a mentor, whilst the majority do not have access to one. There is also limited training for those in mentoring roles. In response, ASiT have implemented a pilot mentoring scheme, with surgical trainees acting both as mentors and mentees. Based on the existing literature, survey data and pilot experience, ASiT formalises in this document consensus recommendations for mentoring in surgical training.

  13. Consensus recommendations for a standardized Brain Tumor Imaging Protocol in clinical trials

    PubMed Central

    Ellingson, Benjamin M.; Bendszus, Martin; Boxerman, Jerrold; Barboriak, Daniel; Erickson, Bradley J.; Smits, Marion; Nelson, Sarah J.; Gerstner, Elizabeth; Alexander, Brian; Goldmacher, Gregory; Wick, Wolfgang; Vogelbaum, Michael; Weller, Michael; Galanis, Evanthia; Kalpathy-Cramer, Jayashree; Shankar, Lalitha; Jacobs, Paula; Pope, Whitney B.; Yang, Dewen; Chung, Caroline; Knopp, Michael V.; Cha, Soonme; van den Bent, Martin J.; Chang, Susan; Al Yung, W.K.; Cloughesy, Timothy F.; Wen, Patrick Y.; Gilbert, Mark R.

    2015-01-01

    A recent joint meeting was held on January 30, 2014, with the US Food and Drug Administration (FDA), National Cancer Institute (NCI), clinical scientists, imaging experts, pharmaceutical and biotech companies, clinical trials cooperative groups, and patient advocate groups to discuss imaging endpoints for clinical trials in glioblastoma. This workshop developed a set of priorities and action items including the creation of a standardized MRI protocol for multicenter studies. The current document outlines consensus recommendations for a standardized Brain Tumor Imaging Protocol (BTIP), along with the scientific and practical justifications for these recommendations, resulting from a series of discussions between various experts involved in aspects of neuro-oncology neuroimaging for clinical trials. The minimum recommended sequences include: (i) parameter-matched precontrast and postcontrast inversion recovery-prepared, isotropic 3D T1-weighted gradient-recalled echo; (ii) axial 2D T2-weighted turbo spin-echo acquired after contrast injection and before postcontrast 3D T1-weighted images to control timing of images after contrast administration; (iii) precontrast, axial 2D T2-weighted fluid-attenuated inversion recovery; and (iv) precontrast, axial 2D, 3-directional diffusion-weighted images. Recommended ranges of sequence parameters are provided for both 1.5 T and 3 T MR systems. PMID:26250565

  14. Advances in renal neoplasia: recommendations from the 2012 International Society of Urological Pathology Consensus Conference.

    PubMed

    Delahunt, Brett; Srigley, John R; Montironi, Rodolfo; Egevad, Lars

    2014-05-01

    The International Society of Urological Pathology (ISUP) 2012 Consensus Conference made recommendations regarding the classification, prognostic factors, staging, and immunohistochemical and molecular assessment of adult renal tumors. There was consensus that 5 entities should be recognized as novel tumors: tubulocystic renal cell carcinoma (RCC), acquired cystic disease-associated RCC, clear cell papillary RCC, microphthalmia transcription factor-family translocation RCC [in particular t(6; 11) RCC], and hereditary leiomyomatosis RCC syndrome-associated RCC. In addition, 3 rare epithelial carcinomas were considered emerging or provisional entities: thyroid-like follicular RCC, succinate dehydrogenase B deficiency-associated RCC, and anaplastic lymphoma kinase translocation RCC. There were also a number of suggested modifications to existing World Health Organization 2004 categories, with the new classification to be known as the ISUP Vancouver Classification. Tumor morphotype, sarcomatoid/rhabdoid differentiation, and tumor necrosis were identified as significant prognostic parameters for RCC. The ISUP Grading System was accepted with grades 1-3 of clear cell and papillary RCC being based on nucleolar prominence, whereas extreme nuclear pleomorphism or sarcomatoid and/or rhabdoid differentiation defined grade 4 tumors. It was agreed that chromophobe RCC should not be graded. Consensus guidelines were formulated for specimen handling, and it was agreed that renal sinus invasion is present when tumor is in direct contact with fat or loose connective tissue of the sinus or if there is involvement of endothelial-lined spaces within the renal sinus, regardless of the size. The role of biomarkers in the diagnosis and assessment of prognosis of renal tumors was considered, and panels of immunohistochemical markers were identified for use in specific differential diagnostic scenarios.

  15. Canadian consensus recommendations on the management of venous thromboembolism in patients with cancer. Part 1: prophylaxis

    PubMed Central

    Easaw, J.C.; Shea–Budgell, M.A.; Wu, C.M.J.; Czaykowski, P.M.; Kassis, J.; Kuehl, B.; Lim, H.J.; MacNeil, M.; Martinusen, D.; McFarlane, P.A.; Meek, E.; Moodley, O.; Shivakumar, S.; Tagalakis, V.; Welch, S.; Kavan, P.

    2015-01-01

    Patients with cancer are at increased risk of venous thromboembolism (vte). Anticoagulation therapy has been shown to prevent vte; however, unique clinical circumstances in patients with cancer can often complicate the decisions surrounding the administration of prophylactic anticoagulation. No national Canadian guidelines on the prevention of cancer-associated thrombosis have been published. We therefore aimed to develop a consensus-based, evidence-informed guideline on the topic. PubMed was searched for clinical trials and meta-analyses published between 2002 and 2013. Reference lists of key articles were hand-searched for additional publications. Content experts from across Canada were assembled to review the evidence and make recommendations. Low molecular weight heparin can be used prophylactically in cancer patients at high risk of developing vte. Direct oral anticoagulants are not recommended for vte prophylaxis at this time. Specific clinical scenarios, including renal insufficiency, thrombocytopenia, liver disease, and obesity can warrant modifications in the administration of prophylactic anticoagulant therapy. There is no evidence to support the monitoring of anti–factor Xa levels in clinically stable cancer patients receiving prophylactic anticoagulation; however, factor Xa levels could be checked at baseline and periodically in patients with renal insufficiency. The use of anticoagulation therapy to prolong survival in cancer patients without the presence of risk factors for vte is not recommended. PMID:25908912

  16. Treatment of Hyaluronic Acid Filler-Induced Impending Necrosis With Hyaluronidase: Consensus Recommendations.

    PubMed

    Cohen, Joel L; Biesman, Brian S; Dayan, Steven H; DeLorenzi, Claudio; Lambros, Val S; Nestor, Mark S; Sadick, Neil; Sykes, Jonathan

    2015-09-01

    Injection-induced necrosis is a rare but dreaded consequence of soft tissue augmentation with filler agents. It usually occurs as a result of injection of filler directly into an artery, but can also result from compression or injury. We provide recommendations on the use of hyaluronidase when vascular compromise is suspected. Consensus recommendations were developed by thorough discussion and debate amongst the authors at a roundtable meeting on Wednesday June 18, 2014 in Las Vegas, NV as well as significant ongoing written and verbal communications amongst the authors in the months prior to journal submission. All authors are experienced tertiary care providers. A prompt diagnosis and immediate treatment with high doses of hyaluronidase (at least 200 U) are critically important. It is not felt necessary to do a skin test in cases of impending necrosis. Some experts recommend dilution with saline to increase dispersion or lidocaine to aid vasodilation. Additional hyaluronidase should be injected if improvement is not seen within 60 minutes. A warm compress also aids vasodilation, and massage has been shown to help. Some experts advocate the use of nitroglycerin paste, although this area is controversial. Introducing an oral aspirin regimen should help prevent further clot formation due to vascular compromise. In our experience, patients who are diagnosed promptly and treated within 24 hours will usually have the best outcomes.

  17. Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report.

    PubMed

    Clavien, Pierre-Alain; Lesurtel, Mickael; Bossuyt, Patrick M M; Gores, Gregory J; Langer, Bernard; Perrier, Arnaud

    2012-01-01

    Although liver transplantation is a widely accepted treatment for hepatocellular carcinoma (HCC), much controversy remains and there is no generally accepted set of guidelines. An international consensus conference was held on Dec 2-4, 2010, in Zurich, Switzerland, with the aim of reviewing current practice regarding liver transplantation in patients with HCC and to develop internationally accepted statements and guidelines. The format of the conference was based on the Danish model. 19 working groups of experts prepared evidence-based reviews according to the Oxford classification, and drafted recommendations answering 19 specific questions. An independent jury of nine members was appointed to review these submissions and make final recommendations, after debates with the experts and audience at the conference. This report presents the final 37 statements and recommendations, covering assessment of candidates for liver transplantation, criteria for listing in cirrhotic and non-cirrhotic patients, role of tumour downstaging, management of patients on the waiting list, role of living donation, and post-transplant management.

  18. Daylight-mediated photodynamic therapy for actinic damage in Latin America: consensus recommendations.

    PubMed

    Grinblat, Beni; Galimberti, Gaston; Chouela, Edgardo; Sanclemente, Gloria; Lopez, Miguel; Alcala, Daniel; Torezan, Luís; Pantoja, Gonzalo

    2016-03-01

    Although conventional photodynamic therapy (c-PDT) using methyl aminolevulinate cream (MAL) is effective for the treatment of grade I-II facial and scalp actinic keratosis (AK), it is associated with treatment-related pain for some patients. Daylight-mediated PDT (DL-PDT) has shown similar efficacy to c-PDT, was nearly painless, and was well tolerated. Overall, DL-PDT effectively treats AK and offers a simpler and better tolerated treatment option than c-PDT. This consensus panel provided recommendations on the use of DL-PDT in Latin America (LATAM) for the treatment of actinic damage associated with few or multiple AKs. The panel was comprised of eight dermatologists from different LATAM countries who have experience using PDT for the treatment of actinic damage. The panel reviewed the relevant literature and provided personal expertise with regard to using DL-PDT for the treatment of photodamage with or without AK. The recommendations formulated by the expert panel provide evidence-based guidelines on all aspects of DL-PDT for the treatment of actinic damage associated with AK in different regions of LATAM. These recommendations provide guidance for dermatologists to ensure maintenance of efficacy and safety of DL-PDT when treating actinic damage, associated with few or multiple AKs in sun-exposed skin.

  19. Expanding the use of neurotoxins in facial aesthetics: a consensus panel's assessment and recommendations.

    PubMed

    Kane, Michael; Donofrio, Lisa; Ascher, Benjamin; Hexsel, Doris; Monheit, Gary; Rzany, Berthold; Weiss, Robert

    2010-01-01

    Injection of botulinum toxin type A (BoNTA) is the most common nonsurgical aesthetic procedure undertaken in the United States (U.S.). A new formulation of BoNTA (abobotulinumtoxinA, Dysport™) has recently been approved in the U.S. for the treatment of glabellar lines. This product has been used for facial aesthetics in other parts of the world for more than 15 years, whereas in the U.S. a different formulation (onabotulinumtoxinA, Botox® Cosmetic) has been used for many years. The various formulations of neurotoxins are unique and are not interchangeable nor are doses convertible from one product to another, so it is important that recommendations be developed to assist U.S. clinicians in understanding the differences between the two available formulations of BoNTA, which should ensure successful outcomes with these products. A group of worldwide experts on the aesthetic use of BoNTA convened in February 2009 in New York, NY, to review the use of BoNTA and to develop consensus recommendations for the use of the new formulation, since such guidelines previously had only been published in German. This publication summarizes key discussions from the meeting as well as recommendations and suggestions regarding the use of abobotulinumtoxinA in the areas of the face most commonly treated with BoNTA.

  20. [Pulmonary hypertension due to chronic lung disease: Recommendations of the Cologne Consensus Conference 2016].

    PubMed

    Olschewski, H; Behr, J; Bremer, H; Claussen, M; Douschan, P; Halank, M; Held, M; Hoeper, M M; Holt, S; Klose, H; Krüger, S; Lange, T J; Reichenberger, F; Skowasch, D; Ulrich, S; Wilkens, H; Seeger, W

    2016-10-01

    The 2015 European Guidelines on Pulmonary Hypertension did not cover only pulmonary arterial hypertension (PAH) but also some aspects of pulmonary hypertension (PH) associated with chronic lung disease. The European Guidelines point out that the drugs currently used to treat patients with PAH (prostanoids, endothelin receptor antagonists, phosphodiesterase-5 inhibitors, sGC stimulators) have not been sufficiently investigated in other forms of PH. Therefore, the European Guidelines do not recommend the use of these drugs in patients with chronic lung disease and PH. This recommendation, however, is not always in agreement with medical ethics as physicians feel sometimes inclined to treat other form of PH which may affect quality of life and survival of these patients in a similar manner. To this end, it is crucial to consider the severity of both PH and the underlying lung disease. In June 2016, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany, to discuss open and controversial issues surrounding the practical implementation of the European Guidelines. Several working groups were initiated, one of which was dedicated to the diagnosis and treatment of PH in patients with chronic lung disease. The recommendations of this working group are summarized in the present paper.

  1. Chronic edema of the lower extremities: international consensus recommendations for compression therapy clinical research trials.

    PubMed

    Stout, N; Partsch, H; Szolnoky, G; Forner-Cordero, I; Mosti, G; Mortimer, P; Flour, M; Damstra, R; Piller, N; Geyer, M J; Benigni, J-P; Moffat, C; Cornu-Thenard, A; Schingale, F; Clark, M; Chauveau, M

    2012-08-01

    Chronic edema is a multifactorial condition affecting patients with various diseases. Although the pathophysiology of edema varies, compression therapy is a basic tenant of treatment, vital to reducing swelling. Clinical trials are disparate or lacking regarding specific protocols and application recommendations for compression materials and methodology to enable optimal efficacy. Compression therapy is a basic treatment modality for chronic leg edema; however, the evidence base for the optimal application, duration and intensity of compression therapy is lacking. The aim of this document was to present the proceedings of a day-long international expert consensus group meeting that examined the current state of the science for the use of compression therapy in chronic edema. An expert consensus group met in Brighton, UK, in March 2010 to examine the current state of the science for compression therapy in chronic edema of the lower extremities. Panel discussions and open space discussions examined the current literature, clinical practice patterns, common materials and emerging technologies for the management of chronic edema. This document outlines a proposed clinical research agenda focusing on compression therapy in chronic edema. Future trials comparing different compression devices, materials, pressures and parameters for application are needed to enhance the evidence base for optimal chronic oedema management. Important outcomes measures and methods of pressure and oedema quantification are outlined. Future trials are encouraged to optimize compression therapy in chronic edema of the lower extremities.

  2. Center to Advance Palliative Care palliative care clinical care and customer satisfaction metrics consensus recommendations.

    PubMed

    Weissman, David E; Morrison, R Sean; Meier, Diane E

    2010-02-01

    Data collection and analysis are vital for strategic planning, quality improvement, and demonstration of palliative care program impact to hospital administrators, private funders and policymakers. Since 2000, the Center to Advance Palliative Care (CAPC) has provided technical assistance to hospitals, health systems and hospices working to start, sustain, and grow nonhospice palliative care programs. CAPC convened a consensus panel in 2008 to develop recommendations for specific clinical and customer metrics that programs should track. The panel agreed on four key domains of clinical metrics and two domains of customer metrics. Clinical metrics include: daily assessment of physical/psychological/spiritual symptoms by a symptom assessment tool; establishment of patient-centered goals of care; support to patient/family caregivers; and management of transitions across care sites. For customer metrics, consensus was reached on two domains that should be tracked to assess satisfaction: patient/family satisfaction, and referring clinician satisfaction. In an effort to ensure access to reliably high-quality palliative care data throughout the nation, hospital palliative care programs are encouraged to collect and report outcomes for each of the metric domains described here.

  3. Recommendations of the Canadian Consensus Group on the Management of Chronic Myeloid Leukemia

    PubMed Central

    Laneuville, P.; Barnett, M.J.; Bélanger, R.; Couban, S.; Forrest, D.L.; Roy, D.C.; Lipton, J.H.

    2006-01-01

    Chronic myelogenous leukemia (cml) is a disease characterized by the expression of Bcr/Abl, an oncogenic protein tyrosine kinase, and by evolution over time from a relatively benign chronic phase to a rapidly fatal cml blast crisis. Until recently, the standard of care included potentially curative therapy with allogeneic stem cell transplantation, available only to a minority (about 10%) of patients, or medical therapy with interferon-α with or without cytarabine, which helped to prolong the chronic phase of the disease in a minority of patients. The availability of imatinib mesylate, a selective inhibitor of Bcr/Abl approved by Health Canada in 2001, has profoundly altered the clinical and laboratory management of cml. This change in practice has been reviewed by the Canadian Consensus Group on the Management of Chronic Myelogenous Leukemia and has resulted in a new set of recommendations for the optimal care of cml patients. PMID:22792021

  4. Consensus recommendation for meningococcal disease prevention in children and adolescents in the Middle East region.

    PubMed

    Shibl, Atef; Tufenkeji, Haysam; Khalil, Mohamed; Memish, Ziad

    2012-03-01

    Facing the availability of the new generation of quadrivalent meningococcal conjugate vaccines (Menveo®, Menactra® and others pending for license) and their recent implementation in Saudi Arabia, experts from 11 countries of the Middle East region met at a "Meningococcal Leadership Forum" (MLF), which took place in May 2010 in Dubai. The participants of the conference discussed the importance of introducing the concept of conjugate vaccines - especially for children and adolescents - and elaborated a consensus recommendation to support healthcare professionals and decision makers with their expertise. In experts' opinion, conjugate vaccines are the best choice for the prevention of meningococcal disease caused by serogroups A, C, W-135 and Y. As quadrivalent meningococcal conjugate vaccines are registered and available in the Middle East region, they should replace plain polysaccharide vaccines and be integrated in pediatric and adolescent vaccination schedules, including infant vaccination concomitantly with basic EPI vaccines when licensed.

  5. Core Needle Biopsy of the Thyroid: 2016 Consensus Statement and Recommendations from Korean Society of Thyroid Radiology

    PubMed Central

    Na, Dong Gyu; Jung, So Lyung; Kim, Ji-hoon; Sung, Jin Yong; Kim, Kyu Sun; Lee, Jeong Hyun; Shin, Jung Hee; Choi, Yoon Jung; Ha, Eun Ju; Lim, Hyun Kyung; Kim, Soo Jin; Hahn, Soo Yeon; Lee, Kwang Hwi; Choi, Young Jun; Youn, Inyoung; Kim, Young Joong; Ahn, Hye Shin; Ryu, Ji Hwa; Baek, Seon Mi; Sim, Jung Suk; Jung, Chan Kwon; Lee, Joon Hyung

    2017-01-01

    Core needle biopsy (CNB) has been suggested as a complementary diagnostic method to fine-needle aspiration in patients with thyroid nodules. Many recent CNB studies have suggested a more advanced role for CNB, but there are still no guidelines on its use. Therefore, the Task Force Committee of the Korean Society of Thyroid Radiology has developed the present consensus statement and recommendations for the role of CNB in the diagnosis of thyroid nodules. These recommendations are based on evidence from the current literature and expert consensus. PMID:28096731

  6. Canadian consensus recommendations on the management of venous thromboembolism in patients with cancer. Part 2: treatment

    PubMed Central

    Easaw, J.C.; Shea–Budgell, M.A.; Wu, C.M.J.; Czaykowski, P.M.; Kassis, J.; Kuehl, B.; Lim, H.J.; MacNeil, M.; Martinusen, D.; McFarlane, P.A.; Meek, E.; Moodley, O.; Shivakumar, S.; Tagalakis, V.; Welch, S.; Kavan, P.

    2015-01-01

    Patients with cancer are at increased risk of venous thromboembolism (vte). Anticoagulation therapy is used to treat vte; however, patients with cancer have unique clinical circumstances that can often make decisions surrounding the administration of therapeutic anticoagulation complicated. No national Canadian guidelines on the management of established cancer-associated thrombosis have been published. We therefore aimed to develop a consensus-based, evidence-informed guideline on the topic. PubMed was searched for clinical trials and meta-analyses published between 2002 and 2013. Reference lists of key articles were hand-searched for additional publications. Content experts from across Canada were assembled to review the evidence and make recommendations. Low molecular weight heparin is the treatment of choice for cancer patients with established vte. Direct oral anticoagulants are not recommended for the treatment of vte at this time. Specific clinical scenarios, including the presence of an indwelling venous catheter, renal insufficiency, and thrombocytopenia, warrant modifications in the therapeutic administration of anticoagulation therapy. Patients with recurrent vte should receive extended (>3 months) anticoagulant therapy. Incidental vte should generally be treated in the same manner as symptomatic vte. There is no evidence to support the monitoring of anti–factor Xa levels in clinically stable cancer patients receiving prophylactic anticoagulation; however, levels of anti–factor Xa could be checked at baseline and periodically thereafter in patients with renal insufficiency. Follow-up and education about the signs and symptoms of vte are important components of ongoing patient care. PMID:25908913

  7. [Pulmonary hypertension associated with left heart disease: recommendations of the Cologne Consensus Conference 2016].

    PubMed

    Rosenkranz, S; Lang, I M; Blindt, R; Bonderman, D; Bruch, L; Diller, G P; Felgendreher, R; Gerges, C; Hohenforst-Schmidt, W; Holt, S; Jung, C; Kindermann, I; Kramer, T; Kübler, W M; Mitrovic, V; Riedel, A; Rieth, A; Schmeisser, A; Wachter, R; Weil, J; Opitz, C

    2016-10-01

    The 2015 European Guidelines on Diagnosis and Treatment of Pulmonary Hypertension are also valid for Germany. While the guidelines contain detailed recommendations regarding pulmonary arterial hypertension (PAH), they contain only a relatively short paragraph on other, much more common forms of PH such as PH due to left heart disease. Despite the lack of data, targeted PAH treatments are increasingly being used for PH associated with left heart disease. This development is of concern because of limited ressources and the need to base treatments on scientific evidence. On the other hand, PH is a frequent problem that is highly relevant for morbidity and mortality in patients with left heart disease, representing an unmet need of targeted PH therapies. It that sense, the practical implementation of the European Guidelines in Germany requires the consideration of several specific issues and already existing novel data. This requires a detailed commentary to the guidelines, and in some aspects an update already appears necessary. In June 2016, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany. This conference aimed to solve practical and controversial issues surrounding the implementation of the European Guidelines in Germany. To this end, several working groups were initiated, one of which was specifically dedicated to PH associated with left heart disease. This article summarizes the results and recommendations of this working group.

  8. Global Aesthetics Consensus: Botulinum Toxin Type A—Evidence-Based Review, Emerging Concepts, and Consensus Recommendations for Aesthetic Use, Including Updates on Complications

    PubMed Central

    Signorini, Massimo; Liew, Steven; Trindade de Almeida, Ada R.; Wu, Yan; Vieira Braz, André; Fagien, Steven; Goodman, Greg J.; Monheit, Gary; Raspaldo, Hervé

    2016-01-01

    Background: Botulinum toxin type A injection remains the leading nonsurgical cosmetic procedure worldwide, with a high rate of efficacy and patient satisfaction. Methods: A multinational, multidisciplinary group of plastic surgeons and dermatologists convened the Global Aesthetics Consensus Group to develop updated consensus recommendations with a worldwide perspective for botulinum toxin and hyaluronic acid fillers. This publication on botulinum toxin type A considers advances in facial analysis, injection techniques, and avoidance and management of complications. Results: Use of botulinum toxin has evolved from the upper face to also encompass the lower face, neck, and midface. The Global Aesthetics Consensus Group emphasizes an integrative, diagnostic approach. Injection dosage and placement are based on analysis of target muscles in the context of adjacent ones and associated soft and hard tissues. The indication for selection of botulinum toxin as a primary intervention is that excessive muscular contraction is the primary etiology of the facial disharmony to be addressed. Global Aesthetics Consensus Group recommendations demonstrate a paradigm shift toward neuromodulation rather than paralysis, including lower dosing of the upper face, more frequent combination treatment with hyaluronic acid fillers, and intracutaneous injection where indicated to limit depth and degree of action. Conclusions: The accumulation of clinical evidence and experience with botulinum toxin has led to refinements in treatment planning and implementation. The Global Aesthetics Consensus Group advocates an etiology-driven, patient-tailored approach, to enable achievement of optimal efficacy and safety in patient populations that are rapidly diversifying with respect to ethnicity, gender, and age. CLINCAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V. PMID:26910696

  9. Larynx Preservation Clinical Trial Design: Key Issues and Recommendations-A Consensus Panel Summary

    SciTech Connect

    Lefebvre, Jean-Louis Ang, K. Kian

    2009-04-01

    Purpose: To develop guidelines for the conduct of Phase III clinical trials of larynx preservation in patients with locally advanced laryngeal and hypopharyngeal cancer. Methods and Materials: A multidisciplinary international consensus panel developed recommendations after reviewing results from completed Phase III randomized trials, meta-analyses, and published clinical reports with updates available through November, 2007. The guidelines were reviewed and approved by the panel. Results: According to the recommendations, the trial population should include patients with T2 or T3 laryngeal or hypopharyngeal squamous cell carcinoma not considered for partial laryngectomy and exclude those with laryngeal dysfunction or age greater than 70 years. Functional assessments should include speech and swallowing. Voice should be routinely assessed with a simple, validated instrument. The primary endpoint should capture survival and function. The panel created a new endpoint: laryngo-esophageal dysfunction-free survival. Events are death, local relapse, total or partial laryngectomy, tracheotomy at 2 years or later, or feeding tube at 2 years or later. Recommended secondary endpoints are overall survival, progression-free survival, locoregional control, time to tracheotomy, time to laryngectomy, time to discontinuation of feeding tube, and quality of life/patient-reported outcomes. Correlative biomarker studies for near-term trials should include estimated glomerular filtration rate, excision repair cross-complementary-1 gene, E-cadherin and {beta}-catenin, epiregulin and amphiregulin, and TP53 mutation. Conclusions: Revised trial designs in several key areas are needed to advance the study of larynx preservation. With consistent methodologies, clinical trials can more effectively evaluate and quantify the therapeutic benefit of novel treatment options for patients with locally advanced laryngeal and hypopharyngeal cancer.

  10. Radiotherapy Technical Considerations in the Management of Locally Advanced Pancreatic Cancer: American-French Consensus Recommendations

    SciTech Connect

    Huguet, Florence; Goodman, Karyn A.; Azria, David; Racadot, Severine; Abrams, Ross A.

    2012-08-01

    Summary: Pancreatic carcinoma is a leading cause of cancer-related mortality. Approximately 30% of pancreatic cancer patients present with locally advanced, unresectable nonmetastatic disease. For these patients, two therapeutic options exist: systemic chemotherapy or chemoradiotherapy. Within this context, the optimal technique for pancreatic irradiation is not clearly defined. A search to identify relevant studies was undertaken using the Medline database. All Phase III randomized trials evaluating the modalities of radiotherapy in locally advanced pancreatic cancer were included, as were some noncontrolled Phase II and retrospective studies. An expert panel convened with members of the Radiation Therapy Oncology Group and GERCOR cooperative groups to review identified studies and prepare the guidelines. Each member of the working group independently evaluated five endpoints: total dose, target volume definition, radiotherapy planning technique, dose constraints to organs at risk, and quality assurance. Based on this analysis of the literature, we recommend either three-dimensional conformal radiation therapy or intensity-modulated radiation therapy to a total dose of 50 to 54 Gy at 1.8 to 2 Gy per fraction. We propose gross tumor volume identification to be followed by an expansion of 1.5 to 2 cm anteriorly, posteriorly, and laterally, and 2 to 3 cm craniocaudally to generate the planning target volume. The craniocaudal margins can be reduced with the use of respiratory gating. Organs at risk are liver, kidneys, spinal cord, stomach, and small bowel. Stereotactic body radiation therapy should not be used for pancreatic cancer outside of clinical trials. Radiotherapy quality assurance is mandatory in clinical trials. These consensus recommendations are proposed for use in the development of future trials testing new chemotherapy combinations with radiotherapy. Not all of these recommendations will be appropriate for trials testing radiotherapy dose or dose

  11. Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine

    PubMed Central

    Paruthi, Shalini; Brooks, Lee J.; D'Ambrosio, Carolyn; Hall, Wendy A.; Kotagal, Suresh; Lloyd, Robin M.; Malow, Beth A.; Maski, Kiran; Nichols, Cynthia; Quan, Stuart F.; Rosen, Carol L.; Troester, Matthew M.; Wise, Merrill S.

    2016-01-01

    Sleep is essential for optimal health in children and adolescents. Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. The recommendations are summarized here. A manuscript detailing the conference proceedings and the evidence supporting these recommendations will be published in the Journal of Clinical Sleep Medicine. Citation: Paruthi S, Brooks LJ, D'Ambrosio C, Hall WA, Kotagal S, Lloyd RM, Malow BA, Maski K, Nichols C, Quan SF, Rosen CL, Troester MM, Wise MS. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine. J Clin Sleep Med 2016;12(6):785–786. PMID:27250809

  12. Global Aesthetics Consensus: Avoidance and Management of Complications from Hyaluronic Acid Fillers—Evidence- and Opinion-Based Review and Consensus Recommendations

    PubMed Central

    Liew, Steven; Sundaram, Hema; De Boulle, Koenraad L.; Goodman, Greg J.; Monheit, Gary; Wu, Yan; Trindade de Almeida, Ada R.; Swift, Arthur; Vieira Braz, André

    2016-01-01

    Background: Although the safety profile of hyaluronic acid fillers is favorable, adverse reactions can occur. Clinicians and patients can benefit from ongoing guidance on adverse reactions to hyaluronic acid fillers and their management. Methods: A multinational, multidisciplinary group of experts in cosmetic medicine convened the Global Aesthetics Consensus Group to review the properties and clinical uses of Hylacross and Vycross hyaluronic acid products and develop updated consensus recommendations for early and late complications associated with hyaluronic acid fillers. Results: The consensus panel provided specific recommendations focusing on early and late complications of hyaluronic acid fillers and their management. The impact of patient-, product-, and technique-related factors on such reactions was described. Most of these were noted to be mild and transient. Serious adverse events are rare. Early adverse reactions to hyaluronic acid fillers include vascular infarction and compromise; inflammatory reactions; injection-related events; and inappropriate placement of filler material. Among late reactions are nodules, granulomas, and skin discoloration. Most adverse events can be avoided with proper planning and technique. Detailed understanding of facial anatomy, proper patient and product selection, and appropriate technique can further reduce the risks. Should adverse reactions occur, the clinician must be prepared and have tools available for effective treatment. Conclusions: Adverse reactions with hyaluronic acid fillers are uncommon. Clinicians should take steps to further reduce the risk and be prepared to treat any complications that arise. PMID:27219265

  13. Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report.

    PubMed

    Pajno, Giovanni Battista; Bernardini, Roberto; Peroni, Diego; Arasi, Stefania; Martelli, Alberto; Landi, Massimo; Passalacqua, Giovanni; Muraro, Antonella; La Grutta, Stefania; Fiocchi, Alessandro; Indinnimeo, Luciana; Caffarelli, Carlo; Calamelli, Elisabetta; Comberiati, Pasquale; Duse, Marzia

    2017-01-23

    Allergen-specific immunotherapy (AIT) is currently recognized as a clinically effective treatment for allergic diseases, with a unique disease-modifying effect. AIT was introduced in clinical practice one century ago, and performed in the early years with allergenic extracts of poor quality and definition. After the mechanism of allergic reaction were recognized, the practice of AIT was refined, leading to remarkable improvement in the efficacy and safety profile of the treatment. Currently AIT is accepted and routinely prescribed worldwide for respiratory allergies and hymenoptera venom allergy. Both the subcutaneous (SCIT) and sublingual (SLIT) routes of administration are used in the pediatric population.AIT is recommended in allergic rhinitis/conjunctivitis with/without allergic asthma, with an evidence of specific IgE-sensitization towards clinically relevant inhalant allergens. Long-term studies provided evidence that AIT can also prevent the onset of asthma and of new sensitizations. The favorable response to AIT is strictly linked to adherence to treatment, that lasts 3-5 years. Therefore, several factors should be carefully evaluated before starting this intervention, including the severity of symptoms, pharmacotherapy requirements and children and caregivers' preference and compliance.In recent years, there have been increasing interest in the role of AIT for the treatment of IgE-associated food allergy and extrinsic atopic dermatitis. A growing body of evidence shows that oral immunotherapy represents a promising treatment option for IgE-associated food allergy. On the contrary, there are still controversies on the effectiveness of AIT for patients with atopic dermatitis.This consensus document was promoted by the Italian Society of Pediatric Allergy and Immunology (SIAIP) to provide evidence-based recommendations on AIT in order to implement and optimize current prescription practices of this treatment for allergic children.

  14. Consensus recommendations from the strategic planning summit for pain and palliative care pharmacy practice.

    PubMed

    Herndon, Christopher M; Strassels, Scott A; Strickland, Jennifer M; Kral, Lee A; Craig, David S; Nesbit, Suzanne Amato; Finley, Rebecca S; McPherson, Mary Lynn

    2012-05-01

    Pain and symptoms related to palliative care (pain and palliative care [PPC]) are often undertreated. This is largely owing to the complexity in the provision of care and the potential discrepancy in education among the various health care professionals required to deliver care. Pharmacists are frequently involved in the care of PPC patients, although pharmacy education currently does not offer or require a strong curriculum commitment to this area of practice. The Strategic Planning Summit for the Advancement of Pain and Palliative Care Pharmacy was convened to address opportunities to improve the education of pharmacists and pharmacy students on PPC. Six working groups were charged with objectives to address barriers and opportunities in the areas of student and professional assessment, model curricula, postgraduate training, professional education, and credentialing. Consensus was reached among the working groups and presented to the Summit Advisory Board for adoption. These recommendations will provide guidance on improving the care provided to PPC patients by pharmacists through integrating education at all points along the professional education continuum.

  15. Recommendations for early diagnosis and intervention in autism spectrum disorders: an Italian-Israeli consensus conference.

    PubMed

    Zachor, Ditza A; Curatolo, Paolo

    2014-03-01

    On April 2013 experts in the field of autism from Italy and Israel convened in Jerusalem to discuss and finalize clinical recommendations for early diagnosis and intervention in Autism Spectrum Disorders (ASDs). In this paper, we summarize the results of this Italian-Israeli consensus conference. ASDs constitute a class of severe and heterogeneous neurodevelopmental conditions caused by atypical brain development beginning during early prenatal life, reflecting many genetic, neurobiological and environmental influences. The first clinical signs of ASDs begin to be evident in children between 12 and 18 months of age, often after a period of relatively typical postnatal development. Recent longitudinal studies reveal substantial diversity in developmental trajectories through childhood and adolescence. Some intervention approaches have been demonstrated to be effective in improving core symptoms of ASDs, even if the heterogeneity and developmental nature of the disorder make it implausible that only one specific treatment will be best for all children with ASDs. More randomized control trials (RCTs) on early intervention are needed to identify the most effective strategies and provide the most efficient allocation of resources during the critical early intervention time period. Future research should focus on linking biological phenotypes with specific genotypes, thus establishing a foundation for the development of diagnostic screening tools and individualization of treatments.

  16. Clinical review: Consensus recommendations on measurement of blood glucose and reporting glycemic control in critically ill adults

    PubMed Central

    2013-01-01

    The management reporting and assessment of glycemic control lacks standardization. The use of different methods to measure the blood glucose concentration and to report the performance of insulin treatment yields major disparities and complicates the interpretation and comparison of clinical trials. We convened a meeting of 16 experts plus invited observers from industry to discuss and where possible reach consensus on the most appropriate methods to measure and monitor blood glucose in critically ill patients and on how glycemic control should be assessed and reported. Where consensus could not be reached, recommendations on further research and data needed to reach consensus in the future were suggested. Recognizing their clear conflict of interest, industry observers played no role in developing the consensus or recommendations from the meeting. Consensus recommendations were agreed for the measurement and reporting of glycemic control in clinical trials and for the measurement of blood glucose in clinical practice. Recommendations covered the following areas: How should we measure and report glucose control when intermittent blood glucose measurements are used? What are the appropriate performance standards for intermittent blood glucose monitors in the ICU? Continuous or automated intermittent glucose monitoring - methods and technology: can we use the same measures for assessment of glucose control with continuous and intermittent monitoring? What is acceptable performance for continuous glucose monitoring systems? If implemented, these recommendations have the potential to minimize the discrepancies in the conduct and reporting of clinical trials and to improve glucose control in clinical practice. Furthermore, to be fit for use, glucose meters and continuous monitoring systems must match their performance to fit the needs of patients and clinicians in the intensive care setting. See related commentary by Soto-Rivera and Agus, http://ccforum.com/content/17

  17. Ultrasonography Diagnosis and Imaging-Based Management of Thyroid Nodules: Revised Korean Society of Thyroid Radiology Consensus Statement and Recommendations

    PubMed Central

    Shin, Jung Hee; Baek, Jung Hwan; Chung, Jin; Ha, Eun Ju; Kim, Ji-hoon; Lee, Young Hen; Lim, Hyun Kyung; Moon, Won-Jin; Park, Jeong Seon; Choi, Yoon Jung; Hahn, Soo Yeon; Jeon, Se Jeong; Jung, So Lyung; Kim, Dong Wook; Kim, Eun-Kyung; Kwak, Jin Young; Lee, Chang Yoon; Lee, Hui Joong; Lee, Jeong Hyun; Lee, Joon Hyung; Lee, Kwang Hui; Park, Sun-Won; Sung, Jin Young

    2016-01-01

    The rate of detection of thyroid nodules and carcinomas has increased with the widespread use of ultrasonography (US), which is the mainstay for the detection and risk stratification of thyroid nodules as well as for providing guidance for their biopsy and nonsurgical treatment. The Korean Society of Thyroid Radiology (KSThR) published their first recommendations for the US-based diagnosis and management of thyroid nodules in 2011. These recommendations have been used as the standard guidelines for the past several years in Korea. Lately, the application of US has been further emphasized for the personalized management of patients with thyroid nodules. The Task Force on Thyroid Nodules of the KSThR has revised the recommendations for the ultrasound diagnosis and imaging-based management of thyroid nodules. The review and recommendations in this report have been based on a comprehensive analysis of the current literature and the consensus of experts. PMID:27134526

  18. Enhancing research in academic radiology departments: recommendations of the 2003 Consensus Conference.

    PubMed

    Alderson, Philip O; Bresolin, Linda B; Becker, Gary J; Thrall, James H; Dunnick, N Reed; Hillman, Bruce J; Lee, Joseph K T; Nagy, Edward C

    2004-08-01

    Opportunities for funded radiologic research are greater than ever, and the amount of federal funding coming to academic radiology departments is increasing. Even so, many medical school-based radiology departments have little or no research funding. Accordingly, a consensus panel was convened to discuss ways to enhance research productivity and broaden the base of research strength in as many academic radiology departments as possible. The consensus panel included radiologists who have leadership roles in some of the best-funded research departments, radiologists who direct other funded research programs, and radiologists with related expertise. The goals of the consensus panel were to identify the attributes associated with successful research programs and to develop an action plan for radiology research based on these characteristics.

  19. [Bone health in Geneva retirees].

    PubMed

    Biver, E; Durosier, C; Chevalley, T; Rizzoli, R; Ferrari, S

    2015-03-18

    GERICO (Geneva Retirees Cohort) is a cohort of 953 men and women recruited at the age of 65 in Canton of Geneva, Switzerland, providing a picture of bone health at retirement time. Despite few comorbidities and good nutritional intake and vitamin D status, 30% of subjects have a history of vertebral or clinical fracture after the age of 45, 20% of women and 11% of men have osteoporosis assessed by DXA. 22% have a 10-year probability of a major osteoporotic fracture assessed by FRAX greater than 15%, -i.e. the current intervention thresholds recommended in this age-class in Switzerland. Nevertheless, only 1.4% subject benefits of an anti-osteoporotic drug. These data underscore the importance of primary and secondary prevention of osteoporosis and fractures in healthy elderly at time of retirement.

  20. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion.

    PubMed

    Watson, Nathaniel F; Badr, M Safwan; Belenky, Gregory; Bliwise, Donald L; Buxton, Orfeu M; Buysse, Daniel; Dinges, David F; Gangwisch, James; Grandner, Michael A; Kushida, Clete; Malhotra, Raman K; Martin, Jennifer L; Patel, Sanjay R; Quan, Stuart F; Tasali, Esra

    2015-08-01

    The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health.

  1. Clinical Evaluation of Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): Recommendations from the 2013 PANS Consensus Conference

    PubMed Central

    Frankovich, Jennifer; Cooperstock, Michael; Cunningham, Madeleine W.; Latimer, M. Elizabeth; Murphy, Tanya K.; Pasternack, Mark; Thienemann, Margo; Williams, Kyle; Walter, Jolan; Swedo, Susan E.

    2015-01-01

    Abstract On May 23 and 24, 2013, the First PANS Consensus Conference was convened at Stanford University, calling together a geographically diverse group of clinicians and researchers from complementary fields of pediatrics: General and developmental pediatrics, infectious diseases, immunology, rheumatology, neurology, and child psychiatry. Participants were academicians with clinical and research interests in pediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS) in youth, and the larger category of pediatric acute-onset neuropsychiatric syndrome (PANS). The goals were to clarify the diagnostic boundaries of PANS, to develop systematic strategies for evaluation of suspected PANS cases, and to set forth the most urgently needed studies in this field. Presented here is a consensus statement proposing recommendations for the diagnostic evaluation of youth presenting with PANS. PMID:25325534

  2. Handling and staging of renal cell carcinoma: the International Society of Urological Pathology Consensus (ISUP) conference recommendations.

    PubMed

    Trpkov, Kiril; Grignon, David J; Bonsib, Stephen M; Amin, Mahul B; Billis, Athanase; Lopez-Beltran, Antonio; Samaratunga, Hemamali; Tamboli, Pheroze; Delahunt, Brett; Egevad, Lars; Montironi, Rodolfo; Srigley, John R

    2013-10-01

    The International Society of Urologic Pathology 2012 Consensus Conference on renal cancer, through working group 3, focused on the issues of staging and specimen handling of renal tumors. The conference was preceded by an online survey of the International Society of Urologic Pathology members, and the results of this were used to inform the focus of conference discussion. On formal voting a ≥65% majority was considered a consensus agreement. For specimen handling it was agreed that with radical nephrectomy specimens the initial cut should be made along the long axis and that both radical and partial nephrectomy specimens should be inked. It was recommended that sampling of renal tumors should follow a general guideline of sampling 1 block/cm with a minimum of 3 blocks (subject to modification as needed in individual cases). When measuring a renal tumor, the length of a renal vein/caval thrombus should not be part of the measurement of the main tumor mass. In cases with multiple tumors, sampling should include at a minimum the 5 largest tumors. There was a consensus that perinephric fat invasion should be determined by examining multiple perpendicular sections of the tumor/perinephric fat interface and by sampling areas suspicious for invasion. Perinephric fat invasion was defined as either the tumor touching the fat or extending as irregular tongues into the perinephric tissue, with or without desmoplasia. It was agreed upon that renal sinus invasion is present when the tumor is in direct contact with the sinus fat or the loose connective tissue of the sinus, clearly beyond the renal parenchyma, or if there is involvement of any endothelium-lined spaces within the renal sinus, regardless of the size. When invasion of the renal sinus is uncertain, it was recommended that at least 3 blocks of the tumor-renal sinus interface should be submitted. If invasion is grossly evident, or obviously not present (small peripheral tumor), it was agreed that only 1 block was

  3. Consensus expert recommendations for identification and management of asparaginase hypersensitivity and silent inactivation.

    PubMed

    van der Sluis, Inge M; Vrooman, Lynda M; Pieters, Rob; Baruchel, Andre; Escherich, Gabriele; Goulden, Nicholas; Mondelaers, Veerle; Sanchez de Toledo, Jose; Rizzari, Carmelo; Silverman, Lewis B; Whitlock, James A

    2016-03-01

    L-asparaginase is an integral component of therapy for acute lymphoblastic leukemia. However, asparaginase-related complications, including the development of hypersensitivity reactions, can limit its use in individual patients. Of considerable concern in the setting of clinical allergy is the development of neutralizing antibodies and associated asparaginase inactivity. Also problematic in the use of asparaginase is the potential for the development of silent inactivation, with the formation of neutralizing antibodies and reduced asparaginase activity in the absence of a clinically evident allergic reaction. Here we present guidelines for the identification and management of clinical hypersensitivity and silent inactivation with Escherichia coli- and Erwinia chrysanthemi- derived asparaginase preparations. These guidelines were developed by a consensus panel of experts following a review of the available published data. We provide a consensus of expert opinions on the role of serum asparaginase level assessment, indications for switching asparaginase preparation, and monitoring after change in asparaginase preparation.

  4. Using Simulations to Improve Electronic Health Record Use, Clinician Training and Patient Safety: Recommendations From A Consensus Conference

    PubMed Central

    Mohan, Vishnu; Woodcock, Deborah; McGrath, Karess; Scholl, Gretchen; Pranaat, Robert; Doberne, Julie W.; Chase, Dian A.; Gold, Jeffrey A.; Ash, Joan S.

    2016-01-01

    A group of informatics experts in simulation, biomedical informatics, patient safety, medical education, and human factors gathered at Corbett, Oregon on April 30 and May 1, 2015. Their objective: to create a consensus statement on best practices for the use of electronic health record (EHR) simulations in education and training, to improve patient safety, and to outline a strategy for future EHR simulation work. A qualitative approach was utilized to analyze data from the conference and generate recommendations in five major categories: (1) Safety, (2) Education and Training, (3) People and Organizations, (4) Usability and Design, and (5) Sociotechnical Aspects. PMID:28269887

  5. Diagnosis, monitoring, and treatment of primary ciliary dyskinesia: PCD foundation consensus recommendations based on state of the art review.

    PubMed

    Shapiro, Adam J; Zariwala, Maimoona A; Ferkol, Thomas; Davis, Stephanie D; Sagel, Scott D; Dell, Sharon D; Rosenfeld, Margaret; Olivier, Kenneth N; Milla, Carlos; Daniel, Sam J; Kimple, Adam J; Manion, Michele; Knowles, Michael R; Leigh, Margaret W

    2016-02-01

    Primary ciliary dyskinesia (PCD) is a genetically heterogeneous, rare lung disease resulting in chronic oto-sino-pulmonary disease in both children and adults. Many physicians incorrectly diagnose PCD or eliminate PCD from their differential diagnosis due to inexperience with diagnostic testing methods. Thus far, all therapies used for PCD are unproven through large clinical trials. This review article outlines consensus recommendations from PCD physicians in North America who have been engaged in a PCD centered research consortium for the last 10 years. These recommendations have been adopted by the governing board of the PCD Foundation to provide guidance for PCD clinical centers for diagnostic testing, monitoring, and appropriate short and long-term therapeutics in PCD patients.

  6. Diagnosis, monitoring, and treatment of primary ciliary dyskinesia: PCD foundation consensus recommendations based on state of the art review

    PubMed Central

    Zariwala, Maimoona A.; Ferkol, Thomas; Davis, Stephanie D.; Sagel, Scott D.; Dell, Sharon D.; Rosenfeld, Margaret; Olivier, Kenneth N.; Milla, Carlos; Daniel, Sam J.; Kimple, Adam J.; Manion, Michele; Knowles, Michael R.; Leigh, Margaret W.

    2015-01-01

    Summary Primary ciliary dyskinesia (PCD) is a genetically heterogeneous, rare lung disease resulting in chronic oto‐sino‐pulmonary disease in both children and adults. Many physicians incorrectly diagnose PCD or eliminate PCD from their differential diagnosis due to inexperience with diagnostic testing methods. Thus far, all therapies used for PCD are unproven through large clinical trials. This review article outlines consensus recommendations from PCD physicians in North America who have been engaged in a PCD centered research consortium for the last 10 years. These recommendations have been adopted by the governing board of the PCD Foundation to provide guidance for PCD clinical centers for diagnostic testing, monitoring, and appropriate short and long‐term therapeutics in PCD patients. Pediatr Pulmonol. 2016;51:115–132. © 2015 The Authors. Pediatric Pulmonology Published by Wiley Periodicals, Inc. PMID:26418604

  7. Optimal use of bendamustine in hematologic disorders: Treatment recommendations from an international consensus panel – an update

    PubMed Central

    Cheson, Bruce D.; Brugger, Wolfram; Damaj, Gandhi; Dreyling, Martin; Kahl, Brad; Kimby, Eva; Ogura, Michinori; Weidmann, Eckhart; Wendtner, Clemens-Martin; Zinzani, Pier Luigi

    2016-01-01

    Abstract Bendamustine has achieved widespread international regulatory approval and is a standard agent for the treatment for chronic lymphocytic leukemia (CLL), indolent non-Hodgkin lymphoma and multiple myeloma. Since approval, the number of indications for bendamustine has expanded to include aggressive non-Hodgkin lymphoma and Hodgkin lymphoma and novel targeted therapies, based on new bendamustine regimens/combinations, are being developed against CLL and lymphomas. In 2010, an international panel of bendamustine experts met and published a set of recommendations on the safe and effective use of bendamustine in patients suffering from hematologic disorders. In 2014, this panel met again to update these recommendations since the clarification of issues including optimal dosing and management of bendamustine-related toxicities. The aim of this report is to communicate the latest consensus on the use of bendamustine, permitting the expansion of its safe and effective administration, particularly in new combination therapies. PMID:26592922

  8. Oncology Gold Standard™ practical consensus recommendations 2016 for treatment of advanced clear cell renal cell carcinoma

    PubMed Central

    Batra, U; Parikh, PM; Prabhash, K; Tongaonkar, HB; Chibber, P; Dabkara, D; Deshmukh, C; Ghadyalpatil, N; Hingmire, S; Joshi, A; Raghunath, SK; Rajappa, S; Rajendranath, R; Rawal, SK; Singh, Manisha; Singh, R; Somashekhar, SP; Sood, R

    2016-01-01

    The Oncology Gold Standard (OGS) Expert Group on renal cell carcinoma (RCC) developed the consensus statement to provide community oncologists practical guidelines on the management of advanced clear cell (cc) RCC using published evidence, practical experience of experts in real life management, and results of a nationwide survey involving 144 health-care professionals. Six broad question categories containing 33 unique questions cover major situations in the routine management of RCC. This document serves as a ready guide for the standard of care to optimize outcome. The table of “Take Home Messages” at the end is a convenient tool for busy practitioners. PMID:28032079

  9. Recommendations for a Core Outcome Set for Measuring Standing Balance in Adult Populations: A Consensus-Based Approach

    PubMed Central

    Sibley, Kathryn M.; Howe, Tracey; Lamb, Sarah E.; Lord, Stephen R.; Maki, Brian E.; Rose, Debra J.; Scott, Vicky; Stathokostas, Liza; Straus, Sharon E.; Jaglal, Susan B.

    2015-01-01

    Background Standing balance is imperative for mobility and avoiding falls. Use of an excessive number of standing balance measures has limited the synthesis of balance intervention data and hampered consistent clinical practice. Objective To develop recommendations for a core outcome set (COS) of standing balance measures for research and practice among adults. Methodology A combination of scoping reviews, literature appraisal, anonymous voting and face-to-face meetings with fourteen invited experts from a range of disciplines with international recognition in balance measurement and falls prevention. Consensus was sought over three rounds using pre-established criteria. Data sources The scoping review identified 56 existing standing balance measures validated in adult populations with evidence of use in the past five years, and these were considered for inclusion in the COS. Results Fifteen measures were excluded after the first round of scoring and a further 36 after round two. Five measures were considered in round three. Two measures reached consensus for recommendation, and the expert panel recommended that at a minimum, either the Berg Balance Scale or Mini Balance Evaluation Systems Test be used when measuring standing balance in adult populations. Limitations Inclusion of two measures in the COS may increase the feasibility of potential uptake, but poses challenges for data synthesis. Adoption of the standing balance COS does not constitute a comprehensive balance assessment for any population, and users should include additional validated measures as appropriate. Conclusions The absence of a gold standard for measuring standing balance has contributed to the proliferation of outcome measures. These recommendations represent an important first step towards greater standardization in the assessment and measurement of this critical skill and will inform clinical research and practice internationally. PMID:25768435

  10. Consensus-based clinical practice recommendations for the examination and management of falls in patients with Parkinson's disease.

    PubMed

    van der Marck, Marjolein A; Klok, Margit Ph C; Okun, Michael S; Giladi, Nir; Munneke, Marten; Bloem, Bastiaan R

    2014-04-01

    Falls in Parkinson's disease (PD) are common and frequently devastating. Falls prevention is an urgent priority, but there is no accepted program that specifically addresses the risk profile in PD. Therefore, we aimed to provide consensus-based clinical practice recommendations that systematically address potential fall risk factors in PD. We developed an overview of both generic (age-related) and PD-specific factors. For each factor, we specified: best method of ascertainment; disciplines that should be involved in assessment and treatment; and which interventions could be engaged. Using a web-based tool, we asked 27 clinically active professionals from multiple relevant disciplines to evaluate this overview. The revised version was subsequently reviewed by 12 experts. Risk factors and their associated interventions were included in the final set of recommendations when at least 66% of reviewing experts agreed. These recommendations included 31 risk factors. Nearly all required a multidisciplinary team approach, usually involving a neurologist and PD-nurse specialist. Finally, the expert panel proposed to first identify the specific fall type and to tailor screening and treatment accordingly. A routine evaluation of all risk factors remains reserved for high-risk patients without prior falls, or for patients with seemingly unexplained falls. In conclusion, this project produced a set of consensus-based clinical practice recommendations for the examination and management of falls in PD. These may be used in two ways: for pragmatic use in current clinical practice, pending further evidence; and as the active intervention in clinical trials, aiming to evaluate the effectiveness and cost-effectiveness of large scale implementation.

  11. Consensus recommendations on the use of daylight photodynamic therapy with methyl aminolevulinate cream for actinic keratoses in Australia

    PubMed Central

    Shumack, Stephen; Murrell, Dedee F; Rubel, Diana M; Fernández‐Peñas, Pablo; Salmon, Robert; Hewitt, Daniel; Foley, Peter; Spelman, Lynda

    2015-01-01

    Abstract Australia has the highest prevalence of actinic keratoses (AK) worldwide. Because of the risk of transformation of AK to invasive squamous cell carcinomas, consensus guidelines recommend that AK are removed using appropriate therapies to prevent progression to invasive disease. Daylight photodynamic therapy (PDT) is emerging as an efficacious treatment for AK, particularly for patients who require treatment of large areas of chronic actinic damage that can be exposed easily to daylight. Daylight PDT with methyl aminolevulinate (MAL) cream is a simple treatment for AK, almost painless, well tolerated and convenient, requiring minimal time in the clinic. Randomised controlled studies from northern Europe and Australia support the use of daylight PDT as an effective therapy for grade I and II AK on the face and scalp. There is sufficient daylight to conduct daylight PDT in Australia at any time of the year and during most weather conditions. Hence, daylight PDT with MAL can be included as an effective and well‐tolerated new treatment option for the treatment of AK in Australia. These consensus recommendations provide guidelines for Australian clinicians on the use of daylight PDT in the treatment of diagnosed AK. PMID:26033230

  12. Dressings as an adjunct to pressure ulcer prevention: consensus panel recommendations.

    PubMed

    Black, Joyce; Clark, Michael; Dealey, Carol; Brindle, Christopher T; Alves, Paulo; Santamaria, Nick; Call, Evan

    2015-08-01

    The formulation of recommendations on the use of wound dressings in pressure ulcer prevention was undertaken by a group of experts in pressure ulcer prevention and treatment from Australia, Portugal, UK and USA. After review of literature, they concluded that there is adequate evidence to recommend the use of five-layer silicone bordered dressings (Mepilex Border Sacrum(®) and 3 layer Mepilex Heel(®) dressings by Mölnlycke Health Care, Gothenburg, Sweden) for pressure ulcer prevention in the sacrum, buttocks and heels in high-risk patients, those in Emergency Department (ED), intensive care unit (ICU) and operating room (OR). Literature on which this recommendation is based includes one prospective randomised control trial, three cohort studies and two case series. Recommendations for dressing use in patients at high risk for pressure injury and shear injury were also provided.

  13. [Consensus document: recommendations for the use of equations to estimate glomerular filtration rate in children].

    PubMed

    Montañés Bermúdez, R; Gràcia Garcia, S; Fraga Rodríguez, G M; Escribano Subias, J; Diez de Los Ríos Carrasco, M J; Alonso Melgar, A; García Nieto, V

    2014-05-01

    The appearance of the K/DOQI guidelines in 2002 on the definition, evaluation and staging of chronic kidney disease (CKD) have led to a major change in how to assess renal function in adults and children. These guidelines, recently updated, recommended that the study of renal function is based, not only on measuring the serum creatinine concentration, but this must be accompanied by the estimation of glomerular filtration rate (GFR) obtained by an equation. However, the implementation of this recommendation in the clinical laboratory reports in the paediatric population has been negligible. Numerous studies have appeared in recent years on the importance of screening and monitoring of patients with CKD, the emergence of new equations for estimating GFR, and advances in clinical laboratories regarding the methods for measuring plasma creatinine and cystatin C, determined by the collaboration between the departments of paediatrics and clinical laboratories to establish recommendations based on the best scientific evidence on the use of equations to estimate GFR in this population. The purpose of this document is to provide recommendations on the evaluation of renal function and the use of equations to estimate GFR in children from birth to 18 years of age. The recipients of these recommendations are paediatricians, nephrologists, clinical biochemistry, clinical analysts, and all health professionals involved in the study and evaluation of renal function in this group of patients.

  14. Consensus document and recommendations on the use of natriuretic peptides in clinical practice.

    PubMed

    Pascual-Figal, D A; Casademont, J; Lobos, J M; Piñera, P; Bayés-Genis, A; Ordóñez-Llanos, J; González-Juanatey, J R

    2016-01-01

    Natriuretic peptides are a useful laboratory tool for the diagnosis, prognosis and treatment of patients with heart failure. Natriuretic peptides are used in various healthcare settings (consultations, emergency department, hospitalization, laboratory) and by various primary care and specialised professionals. However, their use in clinical practice is still scare and uneven. Properly using and interpreting natriuretic peptides in clinical practice requires a minimum of prelaboratory (pathophysiology), laboratory (methods) and postlaboratory (interpretation and integration of clinical data) expertise. The objective of this consensus document, developed by several scientific societies, is to update the necessary concepts and expertise on natriuretic peptides that enable its application in the diagnosis, prognosis and treatment of heart failure, in various healthcare environments.

  15. Consensus Recommendations on Initiating Prescription Therapies for Opioid‐Induced Constipation

    PubMed Central

    Argoff, Charles E.; Brennan, Michael J.; Camilleri, Michael; Davies, Andrew; Fudin, Jeffrey; Galluzzi, Katherine E.; Gudin, Jeffrey; Lembo, Anthony; Stanos, Steven P.

    2015-01-01

    Abstract Objective Aims of this consensus panel were to determine (1) an optimal symptom‐based method for assessing opioid‐induced constipation in clinical practice and (2) a threshold of symptom severity to prompt consideration of prescription therapy. Methods A multidisciplinary panel of 10 experts with extensive knowledge/experience with opioid‐associated adverse events convened to discuss the literature on assessment methods used for opioid‐induced constipation and reach consensus on each objective using the nominal group technique. Results Five validated assessment tools were evaluated: the Patient Assessment of Constipation–Symptoms (PAC‐SYM), Patient Assessment of Constipation–Quality of Life (PAC‐QOL), Stool Symptom Screener (SSS), Bowel Function Index (BFI), and Bowel Function Diary (BF‐Diary). The 3‐item BFI and 4‐item SSS, both clinician administered, are the shortest tools. In published trials, the BFI and 12‐item PAC‐SYM are most commonly used. The 11‐item BF‐Diary is highly relevant in opioid‐induced constipation and was developed and validated in accordance with US Food and Drug Administration guidelines. However, the panel believes that the complex scoring for this tool and the SSS, PAC‐SYM, and 28‐item PAC‐QOL may be unfeasible for clinical practice. The BFI is psychometrically validated and responsive to changes in symptom severity; scores range from 0 to 100, with higher scores indicating greater severity and scores >28.8 points indicating constipation. Conclusions The BFI is a simple assessment tool with a validated threshold of clinically significant constipation. Prescription treatments for opioid‐induced constipation should be considered for patients who have a BFI score of ≥30 points and an inadequate response to first‐line interventions. PMID:26582720

  16. Consensus recommendations from the American Acne & Rosacea Society on the management of rosacea, part 5: a guide on the management of rosacea.

    PubMed

    Del Rosso, James Q; Thiboutot, Diane; Gallo, Richard; Webster, Guy; Tanghetti, Emil; Eichenfield, Lawrence F; Stein-Gold, Linda; Berson, Diane; Zaenglein, Andrea

    2014-03-01

    The last article in this 5-part series provides a final overview of consensus recommendations from the American Acne & Rosacea Society (AARS) on the management of the common presentations of cutaneous rosacea. Optimal management of rosacea requires careful assessment of the patient's clinical features with integration of therapies that adequately treat the presenting signs and symptoms. The treatment consensus recommendations from the AARS are based on 2 major common clinical presentations of rosacea: (1) centrofacial erythema with papulopustular lesions, and (2) centrofacial erythema without papulopustular lesions. The recommendations provided here serve to guide clinicians in their clinical practice.

  17. Recommended implementation of arterial spin-labeled perfusion MRI for clinical applications: A consensus of the ISMRM perfusion study group and the European consortium for ASL in dementia.

    PubMed

    Alsop, David C; Detre, John A; Golay, Xavier; Günther, Matthias; Hendrikse, Jeroen; Hernandez-Garcia, Luis; Lu, Hanzhang; MacIntosh, Bradley J; Parkes, Laura M; Smits, Marion; van Osch, Matthias J P; Wang, Danny J J; Wong, Eric C; Zaharchuk, Greg

    2015-01-01

    This review provides a summary statement of recommended implementations of arterial spin labeling (ASL) for clinical applications. It is a consensus of the ISMRM Perfusion Study Group and the European ASL in Dementia consortium, both of whom met to reach this consensus in October 2012 in Amsterdam. Although ASL continues to undergo rapid technical development, we believe that current ASL methods are robust and ready to provide useful clinical information, and that a consensus statement on recommended implementations will help the clinical community to adopt a standardized approach. In this review, we describe the major considerations and trade-offs in implementing an ASL protocol and provide specific recommendations for a standard approach. Our conclusion is that as an optimal default implementation, we recommend pseudo-continuous labeling, background suppression, a segmented three-dimensional readout without vascular crushing gradients, and calculation and presentation of both label/control difference images and cerebral blood flow in absolute units using a simplified model.

  18. [Vancouver classification of renal tumors: Recommendations of the 2012 consensus conference of the International Society of Urological Pathology (ISUP)].

    PubMed

    Kristiansen, G; Delahunt, B; Srigley, J R; Lüders, C; Lunkenheimer, J-M; Gevensleben, H; Thiesler, T; Montironi, R; Egevad, L

    2015-05-01

    The 2012 consensus conference of the International Society of Urological Pathology (ISUP) has formulated recommendations on classification, prognostic factors and staging as well as immunohistochemistry and molecular pathology of renal tumors. Agreement was reached on the recognition of five new tumor entities: tubulocystic renal cell carcinoma (RCC), acquired cystic kidney disease-associated RCC, clear cell (tubulo) papillary RCC, microphthalmia transcription factor family RCC, in particular t(6;11) RCC and hereditary leiomyomatosis-associated RCC. In addition three rare forms of carcinoma were considered as emerging or provisional entities: thyroid-like follicular RCC, succinate dehydrogenase B deficiency-associated RCC and anaplastic lymphoma kinase (ALK) translocation RCC. In the new ISUP Vancouver classification, modifications to the existing 2004 World Health Organization (WHO) specifications are also suggested. Tumor morphology, a differentiation between sarcomatoid and rhabdoid and tumor necrosis were emphasized as being significant prognostic parameters for RCC. The consensus ISUP grading system assigns clear cell and papillary RCCs to grades 1-3 due to nucleolar prominence and grade 4 is reserved for cases with extreme nuclear pleomorphism, sarcomatoid and/or rhabdoid differentiation. Furthermore, consensus guidelines were established for the preparation of samples. For example, agreement was also reached that renal sinus invasion is diagnosed when the tumor is in direct contact with the fatty tissue or loose connective tissue of the sinus (intrarenal peripelvic fat) or when endothelialized cavities within the renal sinus are invaded by the tumor, independent of the size. The importance of biomarkers for the diagnostics or prognosis of renal tumors was also emphasized and marker profiles were formulated for use in specific differential diagnostics.

  19. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

    PubMed Central

    Watson, Nathaniel F.; Badr, M. Safwan; Belenky, Gregory; Bliwise, Donald L.; Buxton, Orfeu M.; Buysse, Daniel; Dinges, David F.; Gangwisch, James; Grandner, Michael A.; Kushida, Clete; Malhotra, Raman K.; Martin, Jennifer L.; Patel, Sanjay R.; Quan, Stuart F.; Tasali, Esra

    2015-01-01

    The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. Citation: Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. SLEEP 2015;38(8):1161–1183. PMID:26194576

  20. Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

    PubMed Central

    Watson, Nathaniel F.; Badr, M. Safwan; Belenky, Gregory; Bliwise, Donald L.; Buxton, Orfeu M.; Buysse, Daniel; Dinges, David F.; Gangwisch, James; Grandner, Michael A.; Kushida, Clete; Malhotra, Raman K.; Martin, Jennifer L.; Patel, Sanjay R.; Quan, Stuart F.; Tasali, Esra

    2015-01-01

    The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health. Citation: Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. J Clin Sleep Med 2015;11(8):931–952. PMID:26235159

  1. Experts Consensus Recommendations for the Management of Calcium Channel Blocker Poisoning in Adults

    PubMed Central

    Anseeuw, Kurt; Cantrell, Frank Lee; Gilchrist, Ian C.; Hantson, Philippe; Bailey, Benoit; Lavergne, Valéry; Gosselin, Sophie; Kerns, William; Laliberté, Martin; Lavonas, Eric J.; Juurlink, David N.; Muscedere, John; Yang, Chen-Chang; Sinuff, Tasnim; Rieder, Michael; Mégarbane, Bruno

    2017-01-01

    Objective: To provide a management approach for adults with calcium channel blocker poisoning. Data Sources, Study Selection, and Data Extraction: Following the Appraisal of Guidelines for Research & Evaluation II instrument, initial voting statements were constructed based on summaries outlining the evidence, risks, and benefits. Data Synthesis: We recommend 1) for asymptomatic patients, observation and consideration of decontamination following a potentially toxic calcium channel blocker ingestion (1D); 2) as first-line therapies (prioritized based on desired effect), IV calcium (1D), high-dose insulin therapy (1D–2D), and norepinephrine and/or epinephrine (1D). We also suggest dobutamine or epinephrine in the presence of cardiogenic shock (2D) and atropine in the presence of symptomatic bradycardia or conduction disturbance (2D); 3) in patients refractory to the first-line treatments, we suggest incremental doses of high-dose insulin therapy if myocardial dysfunction is present (2D), IV lipid-emulsion therapy (2D), and using a pacemaker in the presence of unstable bradycardia or high-grade arteriovenous block without significant alteration in cardiac inotropism (2D); 4) in patients with refractory shock or who are periarrest, we recommend incremental doses of high-dose insulin (1D) and IV lipid-emulsion therapy (1D) if not already tried. We suggest venoarterial extracorporeal membrane oxygenation, if available, when refractory shock has a significant cardiogenic component (2D), and using pacemaker in the presence of unstable bradycardia or high-grade arteriovenous block in the absence of myocardial dysfunction (2D) if not already tried; 5) in patients with cardiac arrest, we recommend IV calcium in addition to the standard advanced cardiac life-support (1D), lipid-emulsion therapy (1D), and we suggest venoarterial extracorporeal membrane oxygenation if available (2D). Conclusion: We offer recommendations for the stepwise management of calcium channel blocker

  2. Recommendations for self-monitoring in pediatric diabetes: a consensus statement by the ISPED.

    PubMed

    Scaramuzza, Andrea; Cherubini, Valentino; Tumini, Stefano; Bonfanti, Riccardo; Buono, Pietro; Cardella, Francesca; d'Annunzio, Giuseppe; Frongia, Anna Paola; Lombardo, Fortunato; Monciotti, Anna Carla Maria; Rabbone, Ivana; Schiaffini, Riccardo; Toni, Sonia; Zucchini, Stefano; Frontino, Giulio; Iafusco, Dario

    2014-04-01

    A panel of experts of the Italian Society of Pediatric Endocrinology and Diabetology comprehensively discussed and approved the Italian recommendations regarding self-monitoring of blood glucose, continuous glucose monitoring and other measures of glycemic control in children and adolescents with type 1 diabetes. After an extensive review of the literature, we took these issues into account: self-monitoring blood glucose, continuous glucose monitoring, glycemic variability, glycosuria, ketonuria, ketonemia, glycated hemoglobin, fructosamine and glycated albumin, logbook, data downloading, lancing devices, carbohydrate counting, and glycemic measurements at school. We concluded that clinical guidelines on self-management should be developed in every country with faithful adaptation to local languages and taking into account specific contexts and local peculiarities, without any substantial modifications to the international recommendations. We believe that the National Health Service should provide all necessary resources to ensure self-monitoring of blood glucose and possibly continuous glucose monitoring of all children and adolescents with type 1 diabetes, according to the standards of care provided by these recommendations and internationally.

  3. The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension.

    PubMed

    Gibbons, Christopher H; Schmidt, Peter; Biaggioni, Italo; Frazier-Mills, Camille; Freeman, Roy; Isaacson, Stuart; Karabin, Beverly; Kuritzky, Louis; Lew, Mark; Low, Phillip; Mehdirad, Ali; Raj, Satish R; Vernino, Steven; Kaufmann, Horacio

    2017-01-03

    Neurogenic orthostatic hypotension (nOH) is common in patients with neurodegenerative disorders such as Parkinson's disease, multiple system atrophy, pure autonomic failure, dementia with Lewy bodies, and peripheral neuropathies including amyloid or diabetic neuropathy. Due to the frequency of nOH in the aging population, clinicians need to be well informed about its diagnosis and management. To date, studies of nOH have used different outcome measures and various methods of diagnosis, thereby preventing the generation of evidence-based guidelines to direct clinicians towards 'best practices' when treating patients with nOH and associated supine hypertension. To address these issues, the American Autonomic Society and the National Parkinson Foundation initiated a project to develop a statement of recommendations beginning with a consensus panel meeting in Boston on November 7, 2015, with continued communications and contributions to the recommendations through October of 2016. This paper summarizes the panel members' discussions held during the initial meeting along with continued deliberations among the panel members and provides essential recommendations based upon best available evidence as well as expert opinion for the (1) screening, (2) diagnosis, (3) treatment of nOH, and (4) diagnosis and treatment of associated supine hypertension.

  4. Essential Items for Structured Reporting of Rectal Cancer MRI: 2016 Consensus Recommendation from the Korean Society of Abdominal Radiology.

    PubMed

    2017-01-01

    High-resolution rectal MRI plays a crucial role in evaluating rectal cancer by providing multiple prognostic findings and imaging features that guide proper patient management. Quality reporting is critical for accurate effective communication of the information among multiple disciplines, for which a systematic structured approach is beneficial. Existing guides on reporting of rectal MRI are divergent on some issues, largely reflecting the differences in overall management of rectal cancer patients between the United States and Europe. The Korean Society of Abdominal Radiology (KSAR) study group for rectal cancer has developed an expert consensus recommendation regarding essential items for structured reporting of rectal cancer MRI using a modified Delphi method. This recommendation aims at presenting an up-to-date, evidence-based, practical, structured reporting template that can be readily adopted in daily clinical practice. In addition, a thorough explanation of the clinical and scientific rationale underlying the reporting items and their formats is provided. This KSAR recommendation may serve as a useful tool to help achieve more standardized optimal care for rectal cancer patients using rectal MRI.

  5. Essential Items for Structured Reporting of Rectal Cancer MRI: 2016 Consensus Recommendation from the Korean Society of Abdominal Radiology

    PubMed Central

    2017-01-01

    High-resolution rectal MRI plays a crucial role in evaluating rectal cancer by providing multiple prognostic findings and imaging features that guide proper patient management. Quality reporting is critical for accurate effective communication of the information among multiple disciplines, for which a systematic structured approach is beneficial. Existing guides on reporting of rectal MRI are divergent on some issues, largely reflecting the differences in overall management of rectal cancer patients between the United States and Europe. The Korean Society of Abdominal Radiology (KSAR) study group for rectal cancer has developed an expert consensus recommendation regarding essential items for structured reporting of rectal cancer MRI using a modified Delphi method. This recommendation aims at presenting an up-to-date, evidence-based, practical, structured reporting template that can be readily adopted in daily clinical practice. In addition, a thorough explanation of the clinical and scientific rationale underlying the reporting items and their formats is provided. This KSAR recommendation may serve as a useful tool to help achieve more standardized optimal care for rectal cancer patients using rectal MRI. PMID:28096724

  6. Living Donor Kidney Transplantation: Overcoming Disparities in Live Kidney Donation in the US—Recommendations from a Consensus Conference

    PubMed Central

    Rodrigue, James R.; Kazley, Abby Swanson; Mandelbrot, Didier A.; Hays, Rebecca; LaPointe Rudow, Dianne

    2015-01-01

    Despite its superior outcomes relative to chronic dialysis and deceased donor kidney transplantation, live donor kidney transplantation (LDKT) is less likely to occur in minorities, older adults, and poor patients than in those who are white, younger, and have higher household income. In addition, there is considerable geographic variability in LDKT rates. Concomitantly, in recent years, the rate of living kidney donation (LKD) has stopped increasing and is declining, after decades of consistent growth. Particularly noteworthy is the decline in LKD among black, younger, male, and lower-income adults. The Live Donor Community of Practice within the American Society of Transplantation, with financial support from 10 other organizations, held a Consensus Conference on Best Practices in Live Kidney Donation in June 2014. The purpose of this meeting was to identify LKD best practices and knowledge gaps that might influence LDKT, with a focus on patient and donor education, evaluation efficiencies, disparities, and systemic barriers to LKD. In this article, we discuss trends in LDKT/LKD and emerging novel strategies for attenuating disparities, and we offer specific recommendations for future clinical practice, education, research, and policy from the Consensus Conference Workgroup focused on disparities. PMID:25883072

  7. Recommended cognitive outcomes in preclinical Alzheimer's disease: Consensus statement from the European Prevention of Alzheimer's Dementia project.

    PubMed

    Ritchie, Karen; Ropacki, Michael; Albala, Bruce; Harrison, John; Kaye, Jeffrey; Kramer, Joel; Randolph, Christopher; Ritchie, Craig W

    2017-02-01

    The Horizon 2020/IMI European Prevention of Alzheimer's Dementia (EPAD) project will undertake large-scale proof-of-concept trials in predementia Alzheimer's disease (AD). Within EPAD, the monitoring of cognitive trajectories in the preclinical period will constitute a central outcome measure; however, there are currently no clear guidelines as to how this should be achieved as most measures have been developed for the period around dementia diagnosis. The EPAD Scientific Advisory Group for Clinical and Cognitive Outcomes identified appropriate cognitive measures based on a literature search covering both cognitive correlates of preclinical brain changes from imaging studies and cognitive changes observed over time in nondementia population cohorts developing incident dementia. These measures were evaluated according to the following criteria: validity, coherence with biomarker changes, psychometric properties, cross-cultural suitability, availability of alternative forms, and normative data limited practice effects. The resulting consensus statement provides recommendations for both future drug trials and research into preclinical Alzheimer's disease.

  8. Good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) in adults in the UK: a consensus statement.

    PubMed

    Chapman, Ann L N; Seaton, R Andrew; Cooper, Mike A; Hedderwick, Sara; Goodall, Vicky; Reed, Corienne; Sanderson, Frances; Nathwani, Dilip

    2012-05-01

    These good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) are an update to a previous consensus statement on OPAT in the UK published in 1998. They are based on previous national and international guidelines, but have been further developed through an extensive consultation process, and are underpinned by evidence from published literature on OPAT. They provide pragmatic guidance on the development and delivery of OPAT services, looking at all aspects of service design, care delivery, outcome monitoring and quality assurance, with the aim of ensuring that OPAT services provide high-quality, low-risk care, whatever the healthcare setting. They will provide a useful resource for teams developing new services, as well as a practical set of quality indicators for existing services.

  9. Consensus document. Recommendations on assessing proteinuria during the diagnosis and follow-up of chronic kidney disease.

    PubMed

    Montañés Bermúdez, R; Gràcia García, S; Pérez Surribas, D; Martínez Castelao, A; Bover Sanjuán, J

    2011-01-01

    The presence of persistently elevated urinary concentrations of protein or albumin is considered a sign of kidney damage. The diagnosis and staging of chronic kidney disease (CKD) is nowadays based upon the presence of signs of kidney damage together with the estimation of the glomerular filtration rate.The presence of either proteinuria or albuminuria identifies a group of patients with higher risk of CKD progression and higher cardiovascular risk. Treatment with angiotensin converting enzyme inhibitors or angiotensin-receptor blockers,for instance, decreases both the progression of CKD and the incidence of cardiovascular events and death in patients with CKD and proteinuria. Thus, proteinuria is currently considered a therapeutic target by itself. Despite of the importance of detecting and monitoring proteinuria in the diagnosis and follow-up of CKD, there is not a consensus among the clinical practice guidelines published by different scientific societies on the diagnostic cut-off levels, on different sampling procedures,on the units used in laboratory reports or just on whether it should be defined in terms of albumin or proteinuria. The goal of this document, created by the consensus of the Spanish Society of Clinical Biochemistry and Molecular Pathology(SEQC, representing its spanish acronym) and the Spanish Society of Nephrology (S.E.N.), is to recommend to medical and laboratory clinicians appropriate guidelines for the detection and monitorization of proteinuria as a marker of CKD in adults and children. These recommendations result from searching,evaluating and summarizing current scientific evidence published in the last years.

  10. Strategies for addressing adherence problems in patients with serious and persistent mental illness: recommendations from the expert consensus guidelines.

    PubMed

    Velligan, Dawn I; Weiden, Peter J; Sajatovic, Martha; Scott, Jan; Carpenter, Daniel; Ross, Ruth; Docherty, John P

    2010-09-01

    Poor adherence to medication can have devastating consequences for patients with serious mental illness. The literature review and recommendations in this article are reprinted from The Expert Consensus Guideline Series: Adherence Problems in Patients with Serious and Persistent Mental Illness, published in 2009. The expert consensus survey (39 questions, 521 options) on adherence problems in schizophrenia and bipolar disorder was completed by 41 experts in 2008. This article first reviews the literature on interventions aimed at improving adherence. It then presents the experts' recommendations for targeting factors that can contribute to nonadherence and relates them to the literature. The following psychosocial/programmatic and pharmacologic interventions were rated first line for specific problems that can lead to nonadherence: ongoing symptom/ side-effect monitoring for persistent symptoms or side effects; services targeting logistic problems; medication monitoring/environmental supports (e.g., Cognitive Adaptation Training, assertive community treatment) for lack of routines or cognitive deficits; and adjusting the dose or switching to a different oral antipsychotic for persistent side effects (also high second-line for persistent symptoms). Among pharmacologic interventions, the experts gave high second-line ratings to switching to a long-acting antipsychotic when lack of insight, substance use, persistent symptoms, logistic problems, lack of routines, or lack of family/ social support interfere with adherence and to simplifying the treatment regimen when logistic problems, lack of routines, cognitive deficits, or lack of family/social support interfere with adherence. Psychosocial/programmatic interventions that received high second-line ratings in a number of situations included medication monitoring/environmental supports, patient psychoeducation, more frequent and/or longer visits if possible, cognitive behavioral therapy (CBT), family-focused therapy

  11. Human Performance Optimization Metrics: Consensus Findings, Gaps, and Recommendations for Future Research.

    PubMed

    Nindl, Bradley C; Jaffin, Dianna P; Dretsch, Michael N; Cheuvront, Samuel N; Wesensten, Nancy J; Kent, Michael L; Grunberg, Neil E; Pierce, Joseph R; Barry, Erin S; Scott, Jonathan M; Young, Andrew J; OʼConnor, Francis G; Deuster, Patricia A

    2015-11-01

    Human performance optimization (HPO) is defined as "the process of applying knowledge, skills and emerging technologies to improve and preserve the capabilities of military members, and organizations to execute essential tasks." The lack of consensus for operationally relevant and standardized metrics that meet joint military requirements has been identified as the single most important gap for research and application of HPO. In 2013, the Consortium for Health and Military Performance hosted a meeting to develop a toolkit of standardized HPO metrics for use in military and civilian research, and potentially for field applications by commanders, units, and organizations. Performance was considered from a holistic perspective as being influenced by various behaviors and barriers. To accomplish the goal of developing a standardized toolkit, key metrics were identified and evaluated across a spectrum of domains that contribute to HPO: physical performance, nutritional status, psychological status, cognitive performance, environmental challenges, sleep, and pain. These domains were chosen based on relevant data with regard to performance enhancers and degraders. The specific objectives at this meeting were to (a) identify and evaluate current metrics for assessing human performance within selected domains; (b) prioritize metrics within each domain to establish a human performance assessment toolkit; and (c) identify scientific gaps and the needed research to more effectively assess human performance across domains. This article provides of a summary of 150 total HPO metrics across multiple domains that can be used as a starting point-the beginning of an HPO toolkit: physical fitness (29 metrics), nutrition (24 metrics), psychological status (36 metrics), cognitive performance (35 metrics), environment (12 metrics), sleep (9 metrics), and pain (5 metrics). These metrics can be particularly valuable as the military emphasizes a renewed interest in Human Dimension efforts

  12. Evidence-based risk assessment and recommendations for physical activity clearance: Consensus Document 2011.

    PubMed

    Warburton, Darren E R; Gledhill, Norman; Jamnik, Veronica K; Bredin, Shannon S D; McKenzie, Don C; Stone, James; Charlesworth, Sarah; Shephard, Roy J

    2011-07-01

    The Physical Activity Readiness Questionnaire (PAR-Q) and the Physical Activity Readiness Medical Evaluation (PARmed-X) are internationally known preparticipation screening tools developed on the basis of expert opinion. The primary purposes of this consensus document were to seek evidence-based support for the PAR-Q and PARmed-X forms, to identify whether further revisions of these instruments are warranted, to determine how people responding positively to questions on the PAR-Q can be safely cleared without medical referral, and to develop exercise clearance procedures appropriate for various clinical conditions across the human lifespan. Seven systematic reviews were conducted, examining physical-activity-related risks and effective risk-stratification procedures for various prevalent chronic conditions. An additional systematic review assessed the risks associated with exercise testing and training of the general population. Two gap areas were identified and evaluated systematically: the role of the qualified exercise professional and the requisite core competencies required by those working with various chronic conditions; and the risks associated with physical activity during pregnancy. The risks associated with being physically inactive are markedly higher than transient risks during and following an acute bout of exercise in both asymptomatic and symptomatic populations across the lifespan. Further refinements of the PAR-Q and the PARmed-X (including online versions of the forms) are required to address the unique limitations imposed by various chronic health conditions, and to allow the inclusion of individuals across their entire lifespan. A probing decision-tree process is proposed to assist in risk stratification and to reduce barriers to physical activity. Qualified exercise professionals will play an essential role in this revised physical activity clearance process.

  13. Treatment for osteoporosis in Australian residential aged care facilities: consensus recommendations for fracture prevention.

    PubMed

    Duque, Gustavo; Close, Jacqueline J; de Jager, Julien P; Ebeling, Peter R; Inderjeeth, Charles; Lord, Stephen; McLachlan, Andrew J; Reid, Ian R; Troen, Bruce R; Sambrook, Philip N

    2010-08-02

    Older people living in residential aged care facilities (RACFs) are at considerably higher risk of suffering fractures than older people living in the community. When admitted to RACFs, patients should be assessed for fracture risk to ensure early implementation of effective fracture prevention measures. Routine or regular determination of calcium and phosphate serum levels in institutionalised older people is not indicated. Opinion is divided about the value of routine measurements of serum concentrations of 25-hydroxyvitamin D, parathyroid hormone and bone turnover markers. The non-pharmacological approach to fracture prevention includes multifactorial programs of falls prevention and the use of hip protectors. Vitamin D supplementation is recommended for all patients in RACFs. Dietary calcium intake should be optimised (1200-1500 mg per day is recommended) and supplementation offered to those with inadequate intake. The decision to prescribe calcium supplements should be guided by patients' tolerance, whether or not they have a history of kidney stones, and emerging data about its cardiovascular safety. Bisphosphonates are the first-choice pharmacological agents for fracture prevention in older persons at high risk. Intravenous administration is as efficient as oral and has the significant advantage of better adherence. Use of strontium ranelate has not been tested on people in RACFs, but evidence in the "old-old" (those aged 75 years and older) suggests it could be a therapeutic option for fracture prevention in this setting. In general, teriparatide should not be considered as a first-line treatment for fracture prevention, particularly for people in RACFs.

  14. Recommendations from the International Consensus Workshop: convergence on an orofacial pain taxonomy.

    PubMed

    Ohrbach, R; List, T; Goulet, J-P; Svensson, P

    2010-10-01

    This 2·5-day workshop was organized by the International RDC/TMD Consortium Network of the International Association for Dental Research and the Orofacial Pain Special Interest Group of the International Association for the Study of Pain. Workshop participation was by invitation based on representation within the field, which included the Consortium Network, the Orofacial Pain Special Interest Group, the National Institute for Dental and Craniofacial Research, American Academy of Orofacial Pain, the European Academy of Craniomandibular Disorders, and the International Headache Society; other disciplines included radiology, psychology, ontology, and patient advocacy. The workshop members were divided into workgroups that reviewed core literature describing the properties of the RDC/TMD, provided recommendations for revision, and suggested relevant research directions. The goals of this workshop were to (i) finalize the revision of the RDC/TMD into a Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), which would be more appropriate for routine clinical implementation, (ii) provide a broad foundation for the further development of suitable diagnostic systems for not only TMD but also oro-facial pain as well, and (iii) provide research recommendations oriented towards improving our understanding of TMD and oro-facial pain. This report provides the full description of the workshop and Executive Summary, and it acknowledges the participants and sponsors.

  15. Plasma cell leukemia: consensus statement on diagnostic requirements, response criteria and treatment recommendations by the International Myeloma Working Group.

    PubMed

    Fernández de Larrea, C; Kyle, R A; Durie, B G M; Ludwig, H; Usmani, S; Vesole, D H; Hajek, R; San Miguel, J F; Sezer, O; Sonneveld, P; Kumar, S K; Mahindra, A; Comenzo, R; Palumbo, A; Mazumber, A; Anderson, K C; Richardson, P G; Badros, A Z; Caers, J; Cavo, M; LeLeu, X; Dimopoulos, M A; Chim, C S; Schots, R; Noeul, A; Fantl, D; Mellqvist, U-H; Landgren, O; Chanan-Khan, A; Moreau, P; Fonseca, R; Merlini, G; Lahuerta, J J; Bladé, J; Orlowski, R Z; Shah, J J

    2013-04-01

    Plasma cell leukemia (PCL) is a rare and aggressive variant of myeloma characterized by the presence of circulating plasma cells. It is classified as either primary PCL occurring at diagnosis or as secondary PCL in patients with relapsed/refractory myeloma. Primary PCL is a distinct clinic-pathological entity with different cytogenetic and molecular findings. The clinical course is aggressive with short remissions and survival duration. The diagnosis is based upon the percentage (≥ 20%) and absolute number (≥ 2 × 10(9)/l) of plasma cells in the peripheral blood. It is proposed that the thresholds for diagnosis be re-examined and consensus recommendations are made for diagnosis, as well as, response and progression criteria. Induction therapy needs to begin promptly and have high clinical activity leading to rapid disease control in an effort to minimize the risk of early death. Intensive chemotherapy regimens and bortezomib-based regimens are recommended followed by high-dose therapy with autologous stem cell transplantation if feasible. Allogeneic transplantation can be considered in younger patients. Prospective multicenter studies are required to provide revised definitions and better understanding of the pathogenesis of PCL.

  16. Oral health for people with special needs: consensus statement on implications and recommendations for the dental profession.

    PubMed

    Glassman, Paul; Henderson, Tim; Helgeson, Michael; Niessen, Linda; Demby, Neal; Miller, Christine; Meyerowitz, Cyril; Ingraham, Rick; Isman, Robert; Noel, David; Tellier, Rolande; Toto, Karen

    2005-08-01

    In November 2004, the Pacific Center for Special Care at the University of the Pacific Arthur A. Dugoni School of Dentistry, with support from the California Dental Association Foundation, hosted a conference to explore the issue of oral health for people with special needs. This conference was held in conjunction with the joint meetings of Pacific's Statewide Task Force on Oral Health for People With Special Needs and Pacific's Statewide Task Force on Oral Health and Aging. These groups of interested stakeholders meet several times a year to discuss the increasing problems faced by people with disabilities, elderly individuals, and other special populations in obtaining access to oral health services and maintaining good oral health. The purpose of this conference was to explore the changing population of people with special needs, analyze the implications for the dental profession and society, and describe systems and strategies that might lead to improved oral health for these populations. This conference also served as a forum for developing oral health recommendations as a part of the California Commission on Aging's Strategic Plan for an Aging Population. Seven nationally recognized speakers presented draft papers on various aspects of this topic. These presentations are published as the additional papers in this and the next issue of the Journal. There was time for audience reaction and discussion with the speakers. The speakers and a designated group of reactors then developed this consensus statement and recommendations for addressing these issues.

  17. Management of patients with advanced prostate cancer: recommendations of the St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) 2015

    PubMed Central

    Gillessen, S.; Omlin, A.; Attard, G.; de Bono, J. S.; Efstathiou, E.; Fizazi, K.; Halabi, S.; Nelson, P. S.; Sartor, O.; Smith, M. R.; Soule, H. R.; Akaza, H.; Beer, T. M.; Beltran, H.; Chinnaiyan, A. M.; Daugaard, G.; Davis, I. D.; De Santis, M.; Drake, C. G.; Eeles, R. A.; Fanti, S.; Gleave, M. E.; Heidenreich, A.; Hussain, M.; James, N. D.; Lecouvet, F. E.; Logothetis, C. J.; Mastris, K.; Nilsson, S.; Oh, W. K.; Olmos, D.; Padhani, A. R.; Parker, C.; Rubin, M. A.; Schalken, J. A.; Scher, H. I.; Sella, A.; Shore, N. D.; Small, E. J.; Sternberg, C. N.; Suzuki, H.; Sweeney, C. J.; Tannock, I. F.; Tombal, B.

    2015-01-01

    The first St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) Expert Panel identified and reviewed the available evidence for the ten most important areas of controversy in advanced prostate cancer (APC) management. The successful registration of several drugs for castration-resistant prostate cancer and the recent studies of chemo-hormonal therapy in men with castration-naïve prostate cancer have led to considerable uncertainty as to the best treatment choices, sequence of treatment options and appropriate patient selection. Management recommendations based on expert opinion, and not based on a critical review of the available evidence, are presented. The various recommendations carried differing degrees of support, as reflected in the wording of the article text and in the detailed voting results recorded in supplementary Material, available at Annals of Oncology online. Detailed decisions on treatment as always will involve consideration of disease extent and location, prior treatments, host factors, patient preferences as well as logistical and economic constraints. Inclusion of men with APC in clinical trials should be encouraged. PMID:26041764

  18. Treatment of colorectal cancer in older patients: International Society of Geriatric Oncology (SIOG) consensus recommendations 2013.

    PubMed

    Papamichael, D; Audisio, R A; Glimelius, B; de Gramont, A; Glynne-Jones, R; Haller, D; Köhne, C-H; Rostoft, S; Lemmens, V; Mitry, E; Rutten, H; Sargent, D; Sastre, J; Seymour, M; Starling, N; Van Cutsem, E; Aapro, M

    2015-03-01

    Colorectal cancer (CRC) is one of the most commonly diagnosed cancers in Europe and worldwide, with the peak incidence in patients >70 years of age. However, as the treatment algorithms for the treatment of patients with CRC become ever more complex, it is clear that a significant percentage of older CRC patients (>70 years) are being less than optimally treated. This document provides a summary of an International Society of Geriatric Oncology (SIOG) task force meeting convened in Paris in 2013 to update the existing expert recommendations for the treatment of older (geriatric) CRC patients published in 2009 and includes overviews of the recent data on epidemiology, geriatric assessment as it relates to surgery and oncology, and the ability of older CRC patients to tolerate surgery, adjuvant chemotherapy, treatment of their metastatic disease including palliative chemotherapy with and without the use of the biologics, and finally the use of adjuvant and palliative radiotherapy in the treatment of older rectal cancer patients. An overview of each area was presented by one of the task force experts and comments invited from other task force members.

  19. US Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus recommendations for the management of non-tuberculous mycobacteria in individuals with cystic fibrosis.

    PubMed

    Floto, R Andres; Olivier, Kenneth N; Saiman, Lisa; Daley, Charles L; Herrmann, Jean-Louis; Nick, Jerry A; Noone, Peadar G; Bilton, Diana; Corris, Paul; Gibson, Ronald L; Hempstead, Sarah E; Koetz, Karsten; Sabadosa, Kathryn A; Sermet-Gaudelus, Isabelle; Smyth, Alan R; van Ingen, Jakko; Wallace, Richard J; Winthrop, Kevin L; Marshall, Bruce C; Haworth, Charles S

    2016-01-01

    Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can cause chronic pulmonary infection, particularly in individuals with pre-existing inflammatory lung disease such as cystic fibrosis (CF). Pulmonary disease caused by NTM has emerged as a major threat to the health of individuals with CF but remains difficult to diagnose and problematic to treat. In response to this challenge, the US Cystic Fibrosis Foundation (CFF) and the European Cystic Fibrosis Society (ECFS) convened an expert panel of specialists to develop consensus recommendations for the screening, investigation, diagnosis and management of NTM pulmonary disease in individuals with CF. Nineteen experts were invited to participate in the recommendation development process. Population, Intervention, Comparison, Outcome (PICO) methodology and systematic literature reviews were employed to inform draft recommendations. An anonymous voting process was used by the committee to reach consensus. All committee members were asked to rate each statement on a scale of: 0, completely disagree, to 9, completely agree; with 80% or more of scores between 7 and 9 being considered 'good' agreement. Additionally, the committee solicited feedback from the CF communities in the USA and Europe and considered the feedback in the development of the final recommendation statements. Three rounds of voting were conducted to achieve 80% consensus for each recommendation statement. Through this process, we have generated a series of pragmatic, evidence-based recommendations for the screening, investigation, diagnosis and treatment of NTM infection in individuals with CF as an initial step in optimising management for this challenging condition.

  20. US Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus recommendations for the management of non-tuberculous mycobacteria in individuals with cystic fibrosis

    PubMed Central

    Olivier, Kenneth N; Saiman, Lisa; Daley, Charles L; Herrmann, Jean-Louis; Nick, Jerry A; Noone, Peadar G; Bilton, Diana; Corris, Paul; Gibson, Ronald L; Hempstead, Sarah E; Koetz, Karsten; Sabadosa, Kathryn A; Sermet-Gaudelus, Isabelle; Smyth, Alan R; van Ingen, Jakko; Wallace, Richard J; Winthrop, Kevin L; Marshall, Bruce C; Haworth, Charles S

    2016-01-01

    Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can cause chronic pulmonary infection, particularly in individuals with pre-existing inflammatory lung disease such as cystic fibrosis (CF). Pulmonary disease caused by NTM has emerged as a major threat to the health of individuals with CF but remains difficult to diagnose and problematic to treat. In response to this challenge, the US Cystic Fibrosis Foundation (CFF) and the European Cystic Fibrosis Society (ECFS) convened an expert panel of specialists to develop consensus recommendations for the screening, investigation, diagnosis and management of NTM pulmonary disease in individuals with CF. Nineteen experts were invited to participate in the recommendation development process. Population, Intervention, Comparison, Outcome (PICO) methodology and systematic literature reviews were employed to inform draft recommendations. An anonymous voting process was used by the committee to reach consensus. All committee members were asked to rate each statement on a scale of: 0, completely disagree, to 9, completely agree; with 80% or more of scores between 7 and 9 being considered ‘good’ agreement. Additionally, the committee solicited feedback from the CF communities in the USA and Europe and considered the feedback in the development of the final recommendation statements. Three rounds of voting were conducted to achieve 80% consensus for each recommendation statement. Through this process, we have generated a series of pragmatic, evidence-based recommendations for the screening, investigation, diagnosis and treatment of NTM infection in individuals with CF as an initial step in optimising management for this challenging condition. PMID:26666259

  1. SGIM-AMDA-AGS Consensus Best Practice Recommendations for Transitioning Patients' Healthcare from Skilled Nursing Facilities to the Community.

    PubMed

    Lindquist, Lee A; Miller, Rachel K; Saltsman, Wayne S; Carnahan, Jennifer; Rowe, Theresa A; Arbaje, Alicia I; Werner, Nicole; Boockvar, Kenneth; Steinberg, Karl; Baharlou, Shahla

    2017-02-01

    We assembled a cross-cutting team of experts representing primary care physicians (PCPs), home care physicians, physicians who see patients in skilled nursing facilities (SNF physicians), skilled nursing facility medical directors, human factors engineers, transitional care researchers, geriatricians, internists, family practitioners, and three major organizations: AMDA, SGIM, and AGS. This work was sponsored through a grant from the Association of Subspecialty Physicians (ASP). Members of the team mapped the process of discharging patients from a skilled nursing facility into the community and subsequent care of their outpatient PCP. Four areas of process improvement were identified, building on the prior work of the AMDA Transitions of Care Committee and the experiences of the team members. The team identified issues and developed best practices perceived as feasible for SNF physician and PCP practices to accomplish. The goal of these consensus-based recommended best practices is to provide a safe and high-quality transition for patients moving between the care of their SNF physician and PCP.

  2. Myeloproliferative neoplasms working group consensus recommendations for diagnosis and management of primary myelofibrosis, polycythemia vera, and essential thrombocythemia

    PubMed Central

    Agarwal, M. B.; Malhotra, Hemant; Chakrabarti, Prantar; Varma, Neelam; Mathews, Vikram; Bhattacharyya, Jina; Seth, Tulika; Gayathri, K.; Menon, Hari; Subramanian, P. G.; Sharma, Ajay; Bhattacharyya, Maitreyee; Mehta, Jay; Vaid, A. K.; Shah, Sandeep; Aggarwal, Shyam; Gogoi, P. K.; Nair, Reena; Agarwal, Usha; Varma, Subhash; Prasad, S. V. S. S.; Manipadam, Marie Therese

    2015-01-01

    According to the 2008 revision of the World Health Organization (WHO) classification of myeloid malignancies, philadelphia chromosome (Ph)-negative myeloproliferative neoplasms (MPNs) include clonal, hematologic disorders such as polycythemia vera, primary myelofibrosis, and essential thrombocythemia.Recent years have witnessed major advances in the understanding of the molecular pathophysiology of these rare subgroups of chronic, myeloproliferative disorders. Identification of somatic mutations in genes associated with pathogenesis and evolution of these myeloproliferative conditions (Janus Kinase 2; myeloproliferative leukemia virus gene; calreticulin) led to substantial changes in the international guidelines for diagnosis and treatment of Ph-negative MPN during the last few years.The MPN-Working Group (MPN-WG), a panel of hematologists with expertise in MPN diagnosis and treatment from various parts of India, examined applicability of this latest clinical and scientific evidence in the context of hematology practice in India.This manuscript summarizes the consensus recommendations formulated by the MPN-WG that can be followed as a guideline for management of patients with Ph-negative MPN in the context of clinical practice in India. PMID:25810569

  3. US Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus recommendations for the management of non-tuberculous mycobacteria in individuals with cystic fibrosis: executive summary.

    PubMed

    Floto, R Andres; Olivier, Kenneth N; Saiman, Lisa; Daley, Charles L; Herrmann, Jean-Louis; Nick, Jerry A; Noone, Peadar G; Bilton, Diana; Corris, Paul; Gibson, Ronald L; Hempstead, Sarah E; Koetz, Karsten; Sabadosa, Kathryn A; Sermet-Gaudelus, Isabelle; Smyth, Alan R; van Ingen, Jakko; Wallace, Richard J; Winthrop, Kevin L; Marshall, Bruce C; Haworth, Charles S

    2016-01-01

    Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can cause chronic pulmonary infection, particularly in individuals with pre-existing inflammatory lung disease, such as cystic fibrosis (CF). Pulmonary disease (PD) caused by NTM has emerged as a major threat to the health of individuals with CF, but remains difficult to diagnose and problematic to treat. In response to this challenge, the US Cystic Fibrosis Foundation (CFF) and the European Cystic Fibrosis Society (ECFS) convened a panel of 19 experts to develop consensus recommendations for the screening, investigation, diagnosis and management of NTM-PD in individuals with CF. PICO (population, intervention, comparison, outcome) methodology and systematic literature reviews were employed to inform draft recommendations, which were then modified to achieve consensus and subsequently circulated for public consultation within the USA and European CF communities. We have thus generated a series of pragmatic, evidence-based recommendations as an initial step in optimising management for this challenging condition.

  4. Best practices recommendations in the application of immunohistochemistry in urologic pathology: report from the International Society of Urological Pathology consensus conference.

    PubMed

    Amin, Mahul B; Epstein, Jonathan I; Ulbright, Thomas M; Humphrey, Peter A; Egevad, Lars; Montironi, Rodolfo; Grignon, David; Trpkov, Kiril; Lopez-Beltran, Antonio; Zhou, Ming; Argani, Pedram; Delahunt, Brett; Berney, Daniel M; Srigley, John R; Tickoo, Satish K; Reuter, Victor E

    2014-08-01

    Members of the International Society of Urological Pathology (ISUP) participated in a half-day consensus conference to discuss guidelines and recommendations regarding best practice approaches to use of immunohistochemistry (IHC) in differential diagnostic situations in urologic pathology, including bladder, prostate, testis and, kidney lesions. Four working groups, selected by the ISUP leadership, identified several high-interest topics based on common or relevant challenging diagnostic situations and proposed best practice recommendations, which were discussed by the membership. The overall summary of the discussions and the consensus opinion forms the basis of a series of articles, one for each organ site. This Special Article summarizes the overall recommendations made by the four working groups. It is anticipated that this ISUP effort will be valuable to the entire practicing community in the appropriate use of IHC in diagnostic urologic pathology.

  5. US Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus recommendations for the management of non-tuberculous mycobacteria in individuals with cystic fibrosis: executive summary

    PubMed Central

    Olivier, Kenneth N; Saiman, Lisa; Daley, Charles L; Herrmann, Jean-Louis; Nick, Jerry A; Noone, Peadar G; Bilton, Diana; Corris, Paul; Gibson, Ronald L; Hempstead, Sarah E; Koetz, Karsten; Sabadosa, Kathryn A; Sermet-Gaudelus, Isabelle; Smyth, Alan R; van Ingen, Jakko; Wallace, Richard J; Winthrop, Kevin L; Marshall, Bruce C; Haworth, Charles S

    2016-01-01

    Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can cause chronic pulmonary infection, particularly in individuals with pre-existing inflammatory lung disease, such as cystic fibrosis (CF). Pulmonary disease (PD) caused by NTM has emerged as a major threat to the health of individuals with CF, but remains difficult to diagnose and problematic to treat. In response to this challenge, the US Cystic Fibrosis Foundation (CFF) and the European Cystic Fibrosis Society (ECFS) convened a panel of 19 experts to develop consensus recommendations for the screening, investigation, diagnosis and management of NTM-PD in individuals with CF. PICO (population, intervention, comparison, outcome) methodology and systematic literature reviews were employed to inform draft recommendations, which were then modified to achieve consensus and subsequently circulated for public consultation within the USA and European CF communities. We have thus generated a series of pragmatic, evidence-based recommendations as an initial step in optimising management for this challenging condition. PMID:26678435

  6. Living-Donor Kidney Transplantation: Reducing Financial Barriers to Live Kidney Donation—Recommendations from a Consensus Conference

    PubMed Central

    Rudow, Dianne LaPointe; Milton, Jennifer; Rodrigue, James R.; Schold, Jesse D.; Hays, Rebecca

    2015-01-01

    Live-donor kidney transplantation (LDKT) is the best treatment for eligible people with late-stage kidney disease. Despite this, living kidney donation rates have declined in the United States in recent years. A potential source of this decline is the financial impact on potential and actual living kidney donors (LKDs). Recent evidence indicates that the economic climate may be associated with the decline in LDKT and that there are nontrivial financial ramifications for some LKDs. In June 2014, the American Society of Transplantation’s Live Donor Community of Practice convened a Consensus Conference on Best Practices in Live Kidney Donation. The conference included transplant professionals, patients, and other key stakeholders (with the financial support of 10 other organizations) and sought to identify best practices, knowledge gaps, and opportunities pertaining to living kidney donation. This workgroup was tasked with exploring systemic and financial barriers to living kidney donation. The workgroup reviewed literature that assessed the financial effect of living kidney donation, analyzed employment and insurance factors, discussed international models for addressing direct and indirect costs faced by LKDs, and summarized current available resources. The workgroup developed the following series of recommendations to reduce financial and systemic barriers and achieve financial neutrality for LKDs: (1) allocate resources for standardized reimbursement of LKDs' lost wages and incidental costs; (2) pass legislation to offer employment and insurability protections to LKDs; (3) create an LKD financial toolkit to provide standardized, vetted education to donors and providers about options to maximize donor coverage and minimize financial effect within the current climate; and (4) promote further research to identify systemic barriers to living donation and LDKT to ensure the creation of mitigation strategies. PMID:26002904

  7. Living-Donor Kidney Transplantation: Reducing Financial Barriers to Live Kidney Donation--Recommendations from a Consensus Conference.

    PubMed

    Tushla, Lara; Rudow, Dianne LaPointe; Milton, Jennifer; Rodrigue, James R; Schold, Jesse D; Hays, Rebecca

    2015-09-04

    Live-donor kidney transplantation (LDKT) is the best treatment for eligible people with late-stage kidney disease. Despite this, living kidney donation rates have declined in the United States in recent years. A potential source of this decline is the financial impact on potential and actual living kidney donors (LKDs). Recent evidence indicates that the economic climate may be associated with the decline in LDKT and that there are nontrivial financial ramifications for some LKDs. In June 2014, the American Society of Transplantation's Live Donor Community of Practice convened a Consensus Conference on Best Practices in Live Kidney Donation. The conference included transplant professionals, patients, and other key stakeholders (with the financial support of 10 other organizations) and sought to identify best practices, knowledge gaps, and opportunities pertaining to living kidney donation. This workgroup was tasked with exploring systemic and financial barriers to living kidney donation. The workgroup reviewed literature that assessed the financial effect of living kidney donation, analyzed employment and insurance factors, discussed international models for addressing direct and indirect costs faced by LKDs, and summarized current available resources. The workgroup developed the following series of recommendations to reduce financial and systemic barriers and achieve financial neutrality for LKDs: (1) allocate resources for standardized reimbursement of LKDs' lost wages and incidental costs; (2) pass legislation to offer employment and insurability protections to LKDs; (3) create an LKD financial toolkit to provide standardized, vetted education to donors and providers about options to maximize donor coverage and minimize financial effect within the current climate; and (4) promote further research to identify systemic barriers to living donation and LDKT to ensure the creation of mitigation strategies.

  8. European Organization for Research and Treatment of Cancer and International Society for Cutaneous Lymphoma consensus recommendations for the management of cutaneous B-cell lymphomas.

    PubMed

    Senff, Nancy J; Noordijk, Evert M; Kim, Youn H; Bagot, Martine; Berti, Emilio; Cerroni, Lorenzo; Dummer, Reinhard; Duvic, Madeleine; Hoppe, Richard T; Pimpinelli, Nicola; Rosen, Steven T; Vermeer, Maarten H; Whittaker, Sean; Willemze, Rein

    2008-09-01

    Primary cutaneous B-cell lymphomas (CBCL) represent approximately 20% to 25% of all primary cutaneous lymphomas. With the advent of the World Health Organization-European Organization for Research and Treatment of Cancer (EORTC) Consensus Classification for Cutaneous Lymphomas in 2005, uniform terminology and classification for this rare group of neoplasms were introduced. However, staging procedures and treatment strategies still vary between different cutaneous lymphoma centers, which may be because consensus recommendations for the management of CBCL have never been published. Based on an extensive literature search and discussions within the EORTC Cutaneous Lymphoma Group and the International Society for Cutaneous Lymphomas, the present report aims to provide uniform recommendations for the management of the 3 main groups of CBCL. Because no systematic reviews or (randomized) controlled trials were available, these recommendations are mainly based on retrospective studies and small cohort studies. Despite these limitations, there was consensus among the members of the multidisciplinary expert panel that these recommendations reflect the state-of-the-art management as currently practiced in major cutaneous lymphoma centers. They may therefore contribute to uniform staging and treatment and form the basis for future clinical trials in patients with a CBCL.

  9. ESMO consensus conference on malignant lymphoma: general perspectives and recommendations for prognostic tools in mature B-cell lymphomas and chronic lymphocytic leukaemia.

    PubMed

    Ladetto, M; Buske, C; Hutchings, M; Dreyling, M; Gaidano, G; Le Gouill, S; Luminari, S; Pott, C; Zamò, A; Zucca, E

    2016-12-01

    The European Society for Medical Oncology (ESMO) consensus conference on mature B-cell lymphomas and chronic lymphocytic leukaemia (CLL) was held on 20 June 2015 in Lugano, Switzerland, and included a multidisciplinary panel of 25 leading experts. The aim of the conference was to develop recommendations on critical subjects difficult to consider in detail in the ESMO Clinical Practice Guidelines. The following areas were identified: (i) the elderly patient, (ii) prognostic factors suitable for clinical use and (iii) the 'ultra-high-risk' group. Before the conference, the expert panel was divided into three working groups; each group focused on one of these areas in order to address four clinically relevant questions relating to that topic. All relevant scientific literature, as identified by the experts, was reviewed in advance. During the consensus conference, each working group developed recommendations to address each of the four questions assigned to their group. These recommendations were then presented to the entire panel and a consensus was reached. This manuscript presents recommendations dedicated to the second area of interest, i.e. prognostic factors suitable for clinical use. The four topics [i.e. interim positron emission tomography (PET), TP53 mutations, cell of origin (COO) and minimal residual disease (MRD)] were primarily chosen because of the bulk of available data together with the lack of clear guidance regarding their use in clinical practice and within clinical trials. Results, including a summary of evidence supporting each recommendation, are detailed in this manuscript. The panel acknowledged that detection of TP53 inactivation by deletion or mutation in CLL should be implemented in clinical practice (level of evidence I, strength of recommendation A). Due to their potentially high prognostic value, at least in some lymphoma entities, implementation of interim PET, COO and MRD was highly recommended in the context of clinical trials. All

  10. The Indian National Association for Study of the Liver (INASL) Consensus on Prevention, Diagnosis and Management of Hepatocellular Carcinoma in India: The Puri Recommendations

    PubMed Central

    Kumar, Ashish; Acharya, Subrat K.; Singh, Shivaram P.; Saraswat, Vivek A.; Arora, Anil; Duseja, Ajay; Goenka, Mahesh K.; Jain, Deepali; Kar, Premashish; Kumar, Manoj; Kumaran, Vinay; Mohandas, Kunisshery M.; Panda, Dipanjan; Paul, Shashi B.; Ramachandran, Jeyamani; Ramesh, Hariharan; Rao, Padaki N.; Shah, Samir R.; Sharma, Hanish; Thandassery, Ragesh B.

    2014-01-01

    Hepatocellular carcinoma (HCC) is one of the major causes of morbidity, mortality and healthcare expenditure in patients with chronic liver disease. There are no consensus guidelines on diagnosis and management of HCC in India. The Indian National Association for Study of the Liver (INASL) set up a Task-Force on HCC in 2011, with a mandate to develop consensus guidelines for diagnosis and management of HCC, relevant to disease patterns and clinical practices in India. The Task-Force first identified various contentious issues on various aspects of HCC and these issues were allotted to individual members of the Task-Force who reviewed them in detail. The Task-Force used the Oxford Center for Evidence Based Medicine—Levels of Evidence of 2009 for developing an evidence-based approach. A 2-day round table discussion was held on 9th and 10th February, 2013 at Puri, Odisha, to discuss, debate, and finalize the consensus statements. The members of the Task-Force reviewed and discussed the existing literature at this meeting and formulated the INASL consensus statements for each of the issues. We present here the INASL consensus guidelines (The Puri Recommendations) on prevention, diagnosis and management of HCC in India. PMID:25755608

  11. The Indian National Association for Study of the Liver (INASL) Consensus on Prevention, Diagnosis and Management of Hepatocellular Carcinoma in India: The Puri Recommendations.

    PubMed

    Kumar, Ashish; Acharya, Subrat K; Singh, Shivaram P; Saraswat, Vivek A; Arora, Anil; Duseja, Ajay; Goenka, Mahesh K; Jain, Deepali; Kar, Premashish; Kumar, Manoj; Kumaran, Vinay; Mohandas, Kunisshery M; Panda, Dipanjan; Paul, Shashi B; Ramachandran, Jeyamani; Ramesh, Hariharan; Rao, Padaki N; Shah, Samir R; Sharma, Hanish; Thandassery, Ragesh B

    2014-08-01

    Hepatocellular carcinoma (HCC) is one of the major causes of morbidity, mortality and healthcare expenditure in patients with chronic liver disease. There are no consensus guidelines on diagnosis and management of HCC in India. The Indian National Association for Study of the Liver (INASL) set up a Task-Force on HCC in 2011, with a mandate to develop consensus guidelines for diagnosis and management of HCC, relevant to disease patterns and clinical practices in India. The Task-Force first identified various contentious issues on various aspects of HCC and these issues were allotted to individual members of the Task-Force who reviewed them in detail. The Task-Force used the Oxford Center for Evidence Based Medicine-Levels of Evidence of 2009 for developing an evidence-based approach. A 2-day round table discussion was held on 9th and 10th February, 2013 at Puri, Odisha, to discuss, debate, and finalize the consensus statements. The members of the Task-Force reviewed and discussed the existing literature at this meeting and formulated the INASL consensus statements for each of the issues. We present here the INASL consensus guidelines (The Puri Recommendations) on prevention, diagnosis and management of HCC in India.

  12. Consensus recommendations from the American Acne & Rosacea Society on the management of rosacea, part 3: a status report on systemic therapies.

    PubMed

    Del Rosso, James Q; Thiboutot, Diane; Gallo, Richard; Webster, Guy; Tanghetti, Emil; Eichenfield, Lawrence F; Stein-Gold, Linda; Berson, Diane; Zaenglein, Andrea

    2014-01-01

    The third article in this 5-part series reviews systemic therapies used to treat cutaneous rosacea based on consensus recommendations from the American Acne & Rosacea Society (AARS) on the management of the common presentations of cutaneous rosacea. The consensus recommendations are based on current understanding of research that describes pathophysiologic mechanisms that appear to be operative in rosacea, correlation of these underlying pathophysiologic mechanisms with specific clinical manifestations of rosacea, and outcomes from clinical trials that evaluate therapies for rosacea both as monotherapy and in combination with other agents. Systemic agents used for treatment of rosacea have been administered as oral formulations (ie, tablets, capsules). The only oral agent for rosacea approved by the US Food and Drug Administration (FDA) is a modified-release doxycycline 40-mg capsule. Other non-FDA-approved oral agents also are discussed including other tetracyclines, macrolides, metronidazole, and isotretinoin.

  13. Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment.

    PubMed

    Mathieu, Daniel; Marroni, Alessandro; Kot, Jacek

    2017-03-01

    The tenth European Consensus Conference on Hyperbaric Medicine took place in April 2016, attended by a large delegation of experts from Europe and elsewhere. The focus of the meeting was the revision of the European Committee on Hyperbaric Medicine (ECHM) list of accepted indications for hyperbaric oxygen treatment (HBOT), based on a thorough review of the best available research and evidence-based medicine (EBM). For this scope, the modified GRADE system for evidence analysis, together with the DELPHI system for consensus evaluation, were adopted. The indications for HBOT, including those promulgated by the ECHM previously, were analysed by selected experts, based on an extensive review of the literature and of the available EBM studies. The indications were divided as follows: Type 1, where HBOT is strongly indicated as a primary treatment method, as it is supported by sufficiently strong evidence; Type 2, where HBOT is suggested as it is supported by acceptable levels of evidence; Type 3, where HBOT can be considered as a possible/optional measure, but it is not yet supported by sufficiently strong evidence. For each type, three levels of evidence were considered: A, when the number of randomised controlled trials (RCTs) is considered sufficient; B, when there are some RCTs in favour of the indication and there is ample expert consensus; C, when the conditions do not allow for proper RCTs but there is ample and international expert consensus. For the first time, the conference also issued 'negative' recommendations for those conditions where there is Type 1 evidence that HBOT is not indicated. The conference also gave consensus-agreed recommendations for the standard of practice of HBOT.

  14. Dose calculation formalisms and consensus dosimetry parameters for intravascular brachytherapy dosimetry: Recommendations of the AAPM Therapy Physics Committee Task Group No. 149

    SciTech Connect

    Chiu-Tsao, Sou-Tung; Schaart, Dennis R.; Soares, Christopher G.; Nath, Ravinder

    2007-11-15

    Since the publication of AAPM Task Group 60 report in 1999, a considerable amount of dosimetry data for the three coronary brachytherapy systems in use in the United States has been reported. A subgroup, Task Group 149, of the AAPM working group on Special Brachytherapy Modalities (Bruce Thomadsen, Chair) was charged to develop recommendations for dose calculation formalisms and the related consensus dosimetry parameters. The recommendations of this group are presented here. For the Cordis {sup 192}Ir and Novoste {sup 90}Sr/{sup 90}Y systems, the original TG-43 formalism in spherical coordinates should be used along with the consensus values of the dose rate constant, geometry function, radial dose function, and anisotropy function for the single seeds. Contributions from the single seeds should be added linearly for the calculation of dose distributions from a source train. For the Guidant {sup 32}P wire system, the modified TG-43 formalism in cylindrical coordinates along with the recommended data for the 20 and 27 mm wires should be used. Data tables for the 6, 10, 14, 18, and 22 seed trains of the Cordis system, 30, 40, and 60 mm seed trains of the Novoste system, and the 20 and 27 mm wires of the Guidant system are presented along with our rationale and methodology for selecting the consensus data. Briefly, all available datasets were compared with each other and the consensus dataset was either an average of available data or the one obtained from the most densely populated study; in most cases this was a Monte Carlo calculation.

  15. The Geneva brain collection

    PubMed Central

    Kövari, Enikö; Hof, Patrick R.; Bouras, Constantin

    2011-01-01

    The University of Geneva brain collection was founded at the beginning of the 20th century. Today, it consists of 10,154 formaldehyde- or buffered formaldehyde–fixed brains obtained from the autopsies of the Department of Psychiatry and, since 1971, from the Department of Geriatrics as well. More than 100,000 paraffin-embedded blocks and 200,000 histological slides have also been collected since 1901. From the time of its creation, this collection has served as an important resource for pathological studies and clinicopathological correlations, primarily in the field of dementing illnesses and brain aging research. These materials have permitted a number of original neuropathological observations, such as the classification of Pick’s disease by Constantinidis, or the description of dyshoric angiopathy and laminar sclerosis by Morel. The large number of cases, including some very rare conditions, provides a unique resource and an opportunity for worldwide collaborations. PMID:21599692

  16. Chest electrical impedance tomography examination, data analysis, terminology, clinical use and recommendations: consensus statement of the TRanslational EIT developmeNt stuDy group.

    PubMed

    Frerichs, Inéz; Amato, Marcelo B P; van Kaam, Anton H; Tingay, David G; Zhao, Zhanqi; Grychtol, Bartłomiej; Bodenstein, Marc; Gagnon, Hervé; Böhm, Stephan H; Teschner, Eckhard; Stenqvist, Ola; Mauri, Tommaso; Torsani, Vinicius; Camporota, Luigi; Schibler, Andreas; Wolf, Gerhard K; Gommers, Diederik; Leonhardt, Steffen; Adler, Andy

    2017-01-01

    Electrical impedance tomography (EIT) has undergone 30 years of development. Functional chest examinations with this technology are considered clinically relevant, especially for monitoring regional lung ventilation in mechanically ventilated patients and for regional pulmonary function testing in patients with chronic lung diseases. As EIT becomes an established medical technology, it requires consensus examination, nomenclature, data analysis and interpretation schemes. Such consensus is needed to compare, understand and reproduce study findings from and among different research groups, to enable large clinical trials and, ultimately, routine clinical use. Recommendations of how EIT findings can be applied to generate diagnoses and impact clinical decision-making and therapy planning are required. This consensus paper was prepared by an international working group, collaborating on the clinical promotion of EIT called TRanslational EIT developmeNt stuDy group. It addresses the stated needs by providing (1) a new classification of core processes involved in chest EIT examinations and data analysis, (2) focus on clinical applications with structured reviews and outlooks (separately for adult and neonatal/paediatric patients), (3) a structured framework to categorise and understand the relationships among analysis approaches and their clinical roles, (4) consensus, unified terminology with clinical user-friendly definitions and explanations, (5) a review of all major work in thoracic EIT and (6) recommendations for future development (193 pages of online supplements systematically linked with the chief sections of the main document). We expect this information to be useful for clinicians and researchers working with EIT, as well as for industry producers of this technology.

  17. Chest electrical impedance tomography examination, data analysis, terminology, clinical use and recommendations: consensus statement of the TRanslational EIT developmeNt stuDy group

    PubMed Central

    Frerichs, Inéz; Amato, Marcelo B P; van Kaam, Anton H; Tingay, David G; Zhao, Zhanqi; Grychtol, Bartłomiej; Bodenstein, Marc; Gagnon, Hervé; Böhm, Stephan H; Teschner, Eckhard; Stenqvist, Ola; Mauri, Tommaso; Torsani, Vinicius; Camporota, Luigi; Schibler, Andreas; Wolf, Gerhard K; Gommers, Diederik; Leonhardt, Steffen; Adler, Andy

    2017-01-01

    Electrical impedance tomography (EIT) has undergone 30 years of development. Functional chest examinations with this technology are considered clinically relevant, especially for monitoring regional lung ventilation in mechanically ventilated patients and for regional pulmonary function testing in patients with chronic lung diseases. As EIT becomes an established medical technology, it requires consensus examination, nomenclature, data analysis and interpretation schemes. Such consensus is needed to compare, understand and reproduce study findings from and among different research groups, to enable large clinical trials and, ultimately, routine clinical use. Recommendations of how EIT findings can be applied to generate diagnoses and impact clinical decision-making and therapy planning are required. This consensus paper was prepared by an international working group, collaborating on the clinical promotion of EIT called TRanslational EIT developmeNt stuDy group. It addresses the stated needs by providing (1) a new classification of core processes involved in chest EIT examinations and data analysis, (2) focus on clinical applications with structured reviews and outlooks (separately for adult and neonatal/paediatric patients), (3) a structured framework to categorise and understand the relationships among analysis approaches and their clinical roles, (4) consensus, unified terminology with clinical user-friendly definitions and explanations, (5) a review of all major work in thoracic EIT and (6) recommendations for future development (193 pages of online supplements systematically linked with the chief sections of the main document). We expect this information to be useful for clinicians and researchers working with EIT, as well as for industry producers of this technology. PMID:27596161

  18. SCAI/CCAS/SPA expert consensus statement for anesthesia and sedation practice: Recommendations for patients undergoing diagnostic and therapeutic procedures in the pediatric and congenital cardiac catheterization laboratory.

    PubMed

    Odegard, Kirsten C; Vincent, Robert; Baijal, Rahul; Daves, SuAnne; Gray, Robert; Javois, Alex; Love, Barry; Moore, Phil; Nykanen, David; Riegger, Lori; Walker, Scott G; Wilson, Elizabeth C

    2016-11-15

    Current practice of sedation and anesthesia for patients undergoing pediatric congenital cardiac catheterization laboratory (PCCCL) procedures is known to vary among institutions, a multi-society expert panel with representatives from the Congenital Heart Disease Council of the Society for Cardiovascular Angiography and Interventions (SCAI), the Society for Pediatric Anesthesia (SPA) and the Congenital Cardiac Anesthesia Society (CCAS) was convened to evaluate the types of sedation and personnel necessary for procedures performed in the PCCCL. The goal of this panel was to provide practitioners and institutions performing these procedures with guidance consistent with national standards and to provide clinicians and institutions with consensus-based recommendations and the supporting references to encourage their application in quality improvement programs. Recommendations can neither encompass all clinical circumstances nor replace the judgment of individual clinicians in the management of each patient. The science of medicine is rooted in evidence, and the art of medicine is based on the application of this evidence to the individual patient. This expert consensus statement has adhered to these principles for optimal management of patients requiring sedation and anesthesia. What follows are recommendations for patient monitoring in the PCCCL regardless of whether minimal or no sedation is being used or general anesthesia is being provided by an anesthesiologist. © 2016 Wiley Periodicals Inc.

  19. Diagnosis and treatment of pain in plexopathy, radiculopathy, peripheral neuropathy and phantom limb pain. Evidence and recommendations from the Italian Consensus Conference on Pain on Neurorehabilitation.

    PubMed

    Ferraro, Francesco; Jacopetti, Marco; Spallone, Vincenza; Padua, Luca; Traballesi, Marco; Brunelli, Stefano; Cantarella, Cristina; Ciotti, Cristina; Coraci, Daniele; Dalla Toffola, Elena; Mandrini, Silvia; Morone, Giovanni; Pazzaglia, Costanza; Romano, Marcello; Schenone, Angelo; Togni, Rossella; Tamburin, Stefano

    2016-12-01

    Pain may affect all aspects of social life and reduce the quality of life. Neuropathic pain (NP) is common in patients affected by plexopathy, radiculopathy, mononeuropathy, peripheral neuropathy. Phantom limb pain (PLP) is a painful sensation that is common after amputation, and its pathophysiological mechanisms involve changes in the peripheral and central nervous system. Given the lack of conclusive evidence and specific guidelines on these topics, the aim of the Italian Consensus Conference on Pain on Neurorehabilitation (ICCPN) was to collect evidence and offer recommendations to answer currently open questions on the assessment and treatment of NP associated with the above conditions and PLP. When no evidence was available, recommendations were based on consensus between expert opinions. Current guidelines on the assessment and pharmacological treatment of NP can be applied to plexopathy, radiculopathy, mononeuropathy, peripheral neuropathy, while evidence for invasive treatments and physical therapy is generally poor because of the low quality of studies. Treatment of PLP is still unsatisfactory. Data on the functional outcome and impact of pain on neurorehabilitation outcome in these conditions are lacking. In most cases, a multidisciplinary approach is recommended to offer a better outcome and reduce side effects. High quality studies are requested to address the unmet needs in this field.

  20. Primary prophylaxis of invasive fungal diseases in allogeneic stem cell transplantation: revised recommendations from a consensus process by Gruppo Italiano Trapianto Midollo Osseo (GITMO).

    PubMed

    Girmenia, Corrado; Barosi, Giovanni; Piciocchi, Alfonso; Arcese, William; Aversa, Franco; Bacigalupo, Andrea; Bandini, Giuseppe; Bosi, Alberto; Busca, Alessandro; Castagnola, Elio; Caselli, Desiree; Cesaro, Simone; Ciceri, Fabio; Locasciulli, Anna; Locatelli, Franco; Mikulska, Malgorzata; Pagano, Livio; Prete, Arcangelo; Raiola, Anna Maria; Rambaldi, Alessandro

    2014-08-01

    This document updates and expands the recommendations on primary prophylaxis of invasive fungal diseases (IFD) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients, published in 2009 by the Gruppo Italiano Trapianto Midollo Osseo (GITMO). A consensus process was undertaken to describe and evaluate current information and practice regarding risk stratification and primary antifungal prophylaxis during the pre-engraftment and postengraftment phases after allo-HSCT. The revised recommendations were based on the evaluation of recent literature including a large, prospective, multicenter epidemiological study of allo-HSCT recipients conducted among the GITMO transplantation centers during the period of 2008 to 2010. It is intended as a guide for the identification of types and phases of transplantation at low, standard, and high risk for IFD, according to the underlying disease, transplantation, and post-transplantation factors. The risk stratification was the critical determinant of the primary antifungal approach for allo-HSCT recipients.

  1. The future of surgical training in the context of the 'Shape of Training' Review: Consensus recommendations by the Association of Surgeons in Training.

    PubMed

    Harries, Rhiannon L; Williams, Adam P; Ferguson, Henry J M; Mohan, Helen M; Beamish, Andrew J; Gokani, Vimal J

    2016-11-01

    ASiT has long maintained that in order to provide the best quality care to patients in the UK and Republic of Ireland, it is critical that surgeons are trained to the highest standards. In addition, it is imperative that surgery remains an attractive career choice, with opportunities for career progression and job satisfaction to attract and retain the best candidates. In 2013, the Shape of Training review report set out recommendations for the structure and delivery of postgraduate training in light of an ever increasingly poly-morbid and ageing population. This consensus statement outlines ASIT's position regarding recommendations for improving surgical training and aims to help guide discussions with regard to future proposed changes to surgical training.

  2. Recommendations for the transition of patients with ADHD from child to adult healthcare services: a consensus statement from the UK adult ADHD network.

    PubMed

    Young, Susan; Adamou, Marios; Asherson, Philip; Coghill, David; Colley, Bill; Gudjonsson, Gisli; Hollis, Chris; McCarthy, Jane; Müller, Ulrich; Paul, Moli; Pitts, Mark; Arif, Muhammad

    2016-08-26

    The aim of this consensus statement was to discuss transition of patients with ADHD from child to adult healthcare services, and formulate recommendations to facilitate successful transition. An expert workshop was convened in June 2012 by the UK Adult ADHD Network (UKAAN), attended by a multidisciplinary team of mental health professionals, allied professionals and patients. It was concluded that transitions must be planned through joint meetings involving referring/receiving services, patients and their families. Negotiation may be required to balance parental desire for continued involvement in their child's care, and the child's growing autonomy. Clear transition protocols can maintain standards of care, detailing relevant timeframes, responsibilities of agencies and preparing contingencies. Transition should be viewed as a process not an event, and should normally occur by the age of 18, however flexibility is required to accommodate individual needs. Transition is often poorly experienced, and adherence to clear recommendations is necessary to ensure effective transition and prevent drop-out from services.

  3. The role of magnetic resonance imaging (MRI) in focal therapy for prostate cancer: recommendations from a consensus panel

    PubMed Central

    Muller, Berrend G.; Fütterer, Jurgen J.; Gupta, Rajan T.; Katz, Aaron; Kirkham, Alexander; Kurhanewicz, John; Moul, Judd W.; Pinto, Peter A.; Rastinehad, Ardeshir R.; Robertson, Cary; de la Rosette, Jean; Sanchez-Salas, Rafael; Jones, J. Stephen; Ukimura, Osamu; Verma, Sadhna; Wijkstra, Hessel; Marberger, Michael

    2014-01-01

    Objective To establish a consensus on the utility of multiparametric magnetic resonance imaging (mpMRI) to identify patients for focal therapy. Methods Urological surgeons, radiologists, and basic researchers, from Europe and North America participated in a consensus meeting about the use of mpMRI in focal therapy of prostate cancer.The consensus process was face-to-face and specific clinical issues were raised and discussed with agreement sought when possible. All participants are listed among the authors.Topics specifically did not include staging of prostate cancer, but rather identifying the optimal requirements for performing MRI, and the current status of optimally performed mpMRI to (i) determine focality of prostate cancer (e.g. localising small target lesions of ≥0.5 mL), (ii) to monitor and assess the outcome of focal ablation therapies, and (iii) to identify the diagnostic advantages of new MRI methods.In addition, the need for transperineal template saturation biopsies in selecting patients for focal therapy was discussed, if a high quality mpMRI is available. In other words, can mpMRI replace the role of transperineal saturation biopsies in patient selection for focal therapy? Results Consensus was reached on most key aspects of the meeting; however, on definition of the optimal requirements for mpMRI, there was one dissenting voice.mpMRI is the optimum approach to achieve the objectives needed for focal therapy, if made on a high quality machine (3T with/without endorectal coil or 1.5T with endorectal coil) and judged by an experienced radiologist.Structured and standardised reporting of prostate MRI is paramount.State of the art mpMRI is capable of localising small tumours for focal therapy.State of the art mpMRI is the technique of choice for follow-up of focal ablation. Conclusions The present evidence for MRI in focal therapy is limited.mpMRI is not accurate enough to consistently grade tumour aggressiveness.Template-guided saturation biopsies

  4. The International Liaison Committee on Resuscitation (ILCOR) consensus on science with treatment recommendations for pediatric and neonatal patients: pediatric basic and advanced life support.

    PubMed

    2006-05-01

    This publication contains the pediatric and neonatal sections of the 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (COSTR). The consensus process that produced this document was sponsored by the International Liaison Committee on Resuscitation (ILCOR). ILCOR was formed in 1993 and consists of representatives of resuscitation councils from all over the world. Its mission is to identify and review international science and knowledge relevant to cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) and to generate consensus on treatment recommendations. ECC includes all responses necessary to treat life-threatening cardiovascular and respiratory events. The COSTR document presents international consensus statements on the science of resuscitation. ILCOR member organizations are each publishing resuscitation guidelines that are consistent with the science in this consensus document, but they also take into consideration geographic, economic, and system differences in practice and the regional availability of medical devices and drugs. The American Heart Association (AHA) pediatric and the American Academy of Pediatrics/AHA neonatal sections of the resuscitation guidelines are reprinted in this issue of Pediatrics (see pages e978-e988). The 2005 evidence evaluation process began shortly after publication of the 2000 International Guidelines for CPR and ECC. The process included topic identification, expert topic review, discussion and debate at 6 international meetings, further review, and debate within ILCOR member organizations and ultimate approval by the member organizations, an Editorial Board, and peer reviewers. The complete COSTR document was published simultaneously in Circulation (International Liaison Committee on Resuscitation. 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment

  5. Consensus Recommendation for India and Bangladesh for the Use of Pneumococcal Vaccine in Mass Gatherings with Special Reference to Hajj Pilgrims

    PubMed Central

    Mathai, Dilip; Shamsuzzaman, Abul Khair Mohammad; Feroz, Ahrar Ahmed; Virani, Amin R; Hasan, Ashfaq; Ravi Kumar, KL; Ansari, Khalid; Forhad Hossain, Khandaker ATM; Marda, Mahesh; Wahab Zubair, MA; Ali, Mohammed Mukarram; Ashraf, N; Basha, Riyaz; Mirza, Shaeq; Ahmed, Shafeeq; Akhtar, Shamim; Ashraf, Syed Mustafa; Haque, Zahirul

    2016-01-01

    Respiratory tract infections are prevalent among Hajj pilgrims with pneumonia being a leading cause of hospitalization. Streptococcus pneumoniae is a common pathogen isolated from patients with pneumonia and respiratory tract infections during Hajj. There is a significant burden of pneumococcal disease in India, which can be prevented. Guidelines for preventive measures and adult immunization have been published in India, but the implementation of the guidelines is low. Data from Bangladesh are available about significant mortality due to respiratory infections; however, literature regarding guidelines for adult immunization is limited. There is a need for extensive awareness programs across India and Bangladesh. Hence, there was a general consensus about the necessity for a rapid and urgent implementation of measures to prevent respiratory infections in pilgrims traveling to Hajj. About ten countries have developed recommendations for pneumococcal vaccination in Hajj pilgrims: France, the USA, Kuwait, Qatar, Bahrain, the UAE (Dubai Health Authority), Singapore, Malaysia, Egypt, and Indonesia. At any given point whether it is Hajj or Umrah, more than a million people are present in the holy places of Mecca and Madina. Therefore, the preventive measures taken for Hajj apply for Umrah as well. This document puts forward the consensus recommendations by a group of twenty doctors following a closed-door discussion based on the scientific evidence available for India and Bangladesh regarding the prevention of respiratory tract infections in Hajj pilgrims. PMID:27942192

  6. Recommendations

    ERIC Educational Resources Information Center

    Brazelton, G. Blue; Renn, Kristen A.; Stewart, Dafina-Lazarus

    2015-01-01

    In this chapter, the editors provide a summary of the information shared in this sourcebook about the success of students who have minoritized identities of sexuality or gender and offer recommendations for policy, practice, and further research.

  7. Spanish Rheumatology Society and Hospital Pharmacy Society Consensus on recommendations for biologics optimization in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis

    PubMed Central

    Martínez-Fernández, Carmen; Dorantes-Calderón, Benito; García-Vicuña, Rosario; Hernández-Cruz, Blanca; Herrero-Ambrosio, Alicia; Ibarra-Barrueta, Olatz; Martín-Mola, Emilio; Monte-Boquet, Emilio; Morell-Baladrón, Alberto; Sanmartí, Raimon; Sanz-Sanz, Jesús; de Toro-Santos, Francisco Javier; Vela, Paloma; Román Ivorra, José Andrés; Poveda-Andrés, José Luis; Muñoz-Fernández, Santiago

    2015-01-01

    Objective. The aim of this study was to establish guidelines for the optimization of biologic therapies for health professionals involved in the management of patients with RA, AS and PsA. Methods. Recommendations were established via consensus by a panel of experts in rheumatology and hospital pharmacy, based on analysis of available scientific evidence obtained from four systematic reviews and on the clinical experience of panellists. The Delphi method was used to evaluate these recommendations, both between panellists and among a wider group of rheumatologists. Results. Previous concepts concerning better management of RA, AS and PsA were reviewed and, more specifically, guidelines for the optimization of biologic therapies used to treat these diseases were formulated. Recommendations were made with the aim of establishing a plan for when and how to taper biologic treatment in patients with these diseases. Conclusion. The recommendations established herein aim not only to provide advice on how to improve the risk:benefit ratio and efficiency of such treatments, but also to reduce variability in daily clinical practice in the use of biologic therapies for rheumatic diseases. PMID:25526976

  8. [Prevention of Neonatal Group B Sreptococcal Infection. Spanish Recommendations. Update 2012. SEIMC/SEGO/SEN/SEQ/SEMFYC Consensus Document].

    PubMed

    Alós Cortés, Juan Ignacio; Andreu Domingo, Antonia; Arribas Mir, Lorenzo; Cabero Roura, Luis; de Cueto López, Marina; López Sastre, José; Melchor Marcos, Juan Carlos; Puertas Prieto, Alberto; de la Rosa Fraile, Manuel; Salcedo Abizanda, Salvador; Sánchez Luna, Manuel; Sanchez Pérez, María José; Torrejon Cardoso, Rafael

    2013-03-01

    Group B streptococci (GBS) remain the most common cause of early onset neonatal sepsis. In 2003 the Spanish Societies of Obstetrics and Gynaecology, Neonatology, Infectious Diseases and Clinical Microbiology, Chemotherapy, and Family and Community Medicine published updated recommendations for the prevention of early onset neonatal GBS infection. It was recommended to study all pregnant women at 35-37 weeks gestation to determine whether they were colonised by GBS, and to administer intrapartum antibiotic prophylaxis (IAP) to all colonised women. There has been a significant reduction in neonatal GBS infection in Spain following the widespread application of IAP. Today most cases of early onset GBS neonatal infection are due to false negative results in detecting GBS, to the lack of communication between laboratories and obstetric units, and to failures in implementing the prevention protocol. In 2010, new recommendations were published by the CDC, and this fact, together with the new knowledge and experience available, has led to the publishing of these new recommendations. The main changes in these revised recommendations include: microbiological methods to identify pregnant GBS carriers and for testing GBS antibiotic sensitivity, and the antibiotics used for IAP are updated; The significance of the presence of GBS in urine, including criteria for the diagnosis of UTI and asymptomatic bacteriuria in pregnancy are clarified; IAP in preterm labour and premature rupture of membranes, and the management of the newborn in relation to GBS carrier status of the mother are also revised. These recommendations are only addressed to the prevention of GBS early neonatal infection, are not effective against late neonatal infection.

  9. Impact of the 2010 Consensus Recommendations of the Clinical Trial Design Task Force of the NCI Investigational Drug Steering Committee.

    PubMed

    Seymour, Lesley; Groshen, Susan; Rosner, Gary L; Sullivan, Daniel M; Spriggs, David R; Reeves, Steven; Gravell, Amy; Ivy, S Percy; Ratain, Mark J

    2015-11-15

    Oncology phase III trials have a high failure rate, leading to high development costs. The Clinical Trials Design Task Force of the Investigational Drug Steering Committee of the NCI Cancer Therapy and Evaluation Program developed Recommendations regarding the design of phase II trials. We report here on the results of a Concordance Group review charged with documenting whether concordance rates improved after the publication of the Recommendations. One hundred and fifty-five trials were reviewed. Letter of Intents (LOI) from the post-Recommendation period were more likely to be randomized (44% vs. 34%) and biomarker selected (19% vs. 10%). Single-arm studies using time-to-event endpoints (benchmarked against historical data) were similar, as was the type of tumor. There was a significant improvement in the rate of concordance, with 74% of LOIs scored as concordant compared with 58% before the Recommendations (P = 0.042). This included a marked decrease in the use of single-arm designs to evaluate the activity of drug combinations (19% vs. 5%, P = 0.009). There were areas for which clarification was warranted, including the need for protocols to include further development plans, the use of realistic benchmarks, the careful evaluation of historical controls, and the use of a standard treatment option as a control. Ongoing critical evaluation of current trial design methodology and the development of new Guidelines when appropriate will continue to improve drug development ensuring that safe and effective cancer therapeutics are made available to our patients as quickly and efficiently as possible.

  10. [Early pharmacologic treatment with botulinum toxin A in post-stroke spasticity: consensus evidence-based recommendations].

    PubMed

    Lopez de Munain, L; Juan-Garcia, F J; Duarte, E; Martin-Mourelle, R; Rodriguez, S; Moraleda-Perez, S

    2016-10-16

    Spasticity is a common complication that occurs in those patients that have suffered a stroke. To identify those patients at high risk of having post-stroke spasticity and to start treatment at early stages would probably benefit the patient. The key aspects in the early management of post-stroke spasticity were review and the clinical implications and strength of evidences were also considered. The document drafted by the study coordinators was subsequently reviewed and then a validated document was developed. The experts recommend defining early treatment of spasticity as one that begins before the first three months after stroke. The panel considers very important to identify the risk factors associated with the onset of spasticity, since this might reduce its impact. Additionally, the most common conditions subsidiaries of early treatment of both upper and lower limb are defined. The panel recommends that the treatment with botulinum toxin A must only be given by specialists with experience in diagnosis and management of spasticity. In conclusion, the treatment of focal spasticity in the first three months after stroke is indicated in certain situations. These recommendations help to standardize the early management of post-stroke spasticity, with the consequent support to clinicians and patients.

  11. Medical standards for mountain rescue operations using helicopters: official consensus recommendations of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM).

    PubMed

    Tomazin, Iztok; Ellerton, John; Reisten, Oliver; Soteras, Inigo; Avbelj, Miha

    2011-01-01

    The purpose of this article is to establish medical recommendations for safe and effective Helicopter Emergency Medical Systems (HEMS) in countries with a dedicated mountain rescue service. A nonsystematic search was undertaken and a consensus among members of International Commission for Mountain Emergency Medicine (ICAR Medcom) was reached. For the severely injured or ill patient, survival depends on approach time and quality of medical treatment by high-level providers. Helicopters can provide significant shortening of the times involved in mountain rescue. Safety is of utmost importance and everything possible should be done to minimize risk. Even in the mountainous environment, the patient should be reached as quickly as possible (optimally<20 min) and provided with on-site and en-route medical treatment according to international standards. The HEMS unit should be integrated into the Emergency Medical System of the region. All dispatchers should be aware of the specific problems encountered in mountainous areas. The nearest qualified HEMS team to the incident site, regardless of administrative boundaries, should be dispatched. The 'air rescue optimal crew' concept with its flexibility and adaptability of crewmembers ensures that all HEMS tasks can be performed. The helicopter and all equipment should be appropriate for the conditions and specific for mountain related emergencies. These recommendations, agreed by ICAR Medcom, establish recommendations for safe and effective HEMS in mountain rescue.

  12. Consensus recommendations from the American acne & rosacea society on the management of rosacea, part 4: a status report on physical modalities and devices.

    PubMed

    Tanghetti, Emil; Del Rosso, James Q; Thiboutot, Diane; Gallo, Richard; Webster, Guy; Eichenfield, Lawrence F; Stein-Gold, Linda; Berson, Diane; Zaenglein, Andrea

    2014-02-01

    The fourth article in this 5-part series reviews physical modalities and devices used to treat cutaneous rosacea based on consensus recommendations from the American Acne & Rosacea Society (AARS) on the management of the common presentations of cutaneous rosacea. The major therapeutic uses of physical modalities and devices, especially laser and light-based systems, are for treatment of telangiectases and persistent facial erythema (background erythema). Phymas, especially rhinophyma, also are treated with physical modalities such as ablative lasers or surgical devices (eg, electrosurgical loop). Appropriately selected and properly used lasers and intense pulsed light (IPL) devices can successfully address specific clinical manifestations of rosacea that exhibit limited or no response to available medical therapies, such as telangiectases and background centrofacial erythema. Rosacea-associated symptoms also may improve. In most cases, treatment will need to be repeated intermittently to sustain improvement.

  13. Inter-Association Task Force Recommendations on Emergency Preparedness and Management of Sudden Cardiac Arrest in High School and College Athletic Programs: A Consensus Statement

    PubMed Central

    Drezner, Jonathan A; Courson, Ron W; Roberts, William O; Mosesso, Vincent N; Link, Mark S; Maron, Barry J

    2007-01-01

    Objective: To assist high school and college athletic programs prepare for and respond to a sudden cardiac arrest (SCA). This consensus statement summarizes our current understanding of SCA in young athletes, defines the necessary elements for emergency preparedness, and establishes uniform treatment protocols for the management of SCA. Background: Sudden cardiac arrest is the leading cause of death in young athletes. The increasing presence of and timely access to automated external defibrillators (AEDs) at sporting events provides a means of early defibrillation and the potential for effective secondary prevention of sudden cardiac death. An Inter-Association Task Force was sponsored by the National Athletic Trainers' Association to develop consensus recommendations on emergency preparedness and management of SCA in athletes. Recommendations: Comprehensive emergency planning is needed for high school and college athletic programs to ensure an efficient and structured response to SCA. Essential elements of an emergency action plan include establishment of an effective communication system, training of anticipated responders in cardiopulmonary resuscitation and AED use, access to an AED for early defibrillation, acquisition of necessary emergency equipment, coordination and integration of on-site responder and AED programs with the local emergency medical services system, and practice and review of the response plan. Prompt recognition of SCA, early activation of the emergency medical services system, the presence of a trained rescuer to initiate cardiopulmonary resuscitation, and access to early defibrillation are critical in the management of SCA. In any collapsed and unresponsive athlete, SCA should be suspected and an AED applied as soon as possible for rhythm analysis and defibrillation if indicated. PMID:17597956

  14. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition).

    PubMed

    Becker, Patricia; Carney, Liesje Nieman; Corkins, Mark R; Monczka, Jessica; Smith, Elizabeth; Smith, Susan E; Spear, Bonnie A; White, Jane V

    2015-02-01

    The Academy of Nutrition and Dietetics (the Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), utilizing an evidence-informed, consensus-derived process, recommend that a standardized set of diagnostic indicators be used to identify and document pediatric malnutrition (undernutrition) in routine clinical practice. The recommended indicators include z scores for weight-for-height/length, body mass index-for-age, or length/height-for-age or mid-upper arm circumference when a single data point is available. When 2 or more data points are available, indicators may also include weight gain velocity (<2 years of age), weight loss (2-20 years of age), deceleration in weight for length/height z score, and inadequate nutrient intake. The purpose of this consensus statement is to identify a basic set of indicators that can be used to diagnose and document undernutrition in the pediatric population ages 1 month to 18 years. The indicators are intended for use in multiple settings (eg, acute, ambulatory care/outpatient, residential care). Several screening tools have been developed for use in hospitalized children. However, identifying criteria for use in screening for nutritional risk is not the purpose of this paper. Clinicians should use as many data points as available to identify and document the presence of malnutrition. The universal use of a single set of diagnostic parameters will expedite the recognition of pediatric undernutrition, lead to the development of more accurate estimates of its prevalence and incidence, direct interventions, and promote improved outcomes. A standardized diagnostic approach will also inform the prediction of the human and financial responsibilities and costs associated with the prevention and treatment of undernutrition in this vulnerable population and help to further ensure the provision of high-quality, cost-effective nutritional care.

  15. Consensus panel's assessment and recommendations on the use of 3 botulinum toxin type A products in facial aesthetics.

    PubMed

    Lorenc, Z Paul; Kenkel, Jeffrey M; Fagien, Steven; Hirmand, Haideh; Nestor, Mark S; Sclafani, Anthony P; Sykes, Jonathan M; Waldorf, Heidi A

    2013-03-01

    In this summary article, the authors discuss the characteristics of abobotulinumtoxinA, incobotulinumtoxinA, and onabotulinumtoxinA. With 3 neuromodulators available in the US market, comparisons between and among products will invariably be made, so arguments for the most effective facial aesthetic uses of each neuromodulator are presented. Topics addressed in this article include patient expectations, toxin reconstitution and preparation, patient positioning, differences among products, the role of complexing proteins, and dosing and injection strategies. Recommendations are also provided by treatment area.

  16. The non-medical workforce and its role in surgical training: Consensus recommendations by the Association of Surgeons in Training.

    PubMed

    Gokani, Vimal J; Peckham-Cooper, Adam; Bunting, David; Beamish, Andrew J; Williams, Adam; Harries, Rhiannon L

    2016-11-01

    Changes in the delivery of the healthcare structure have led to the expansion of the non-medical workforce (NMW). The non-medical practitioner in surgery (a healthcare professional without a medical degree who undertakes specialist training) is a valuable addition to a surgical firm. However, there are a number of challenges regarding the successful widespread implementation of this role. This paper outlines a number of these concerns, and makes recommendations to aid the realisation of the non-medical practitioner as a normal part of the surgical team. In summary, the Association of Surgeons in Training welcomes the development of the non-medical workforce as part of the surgical team in order to promote enhanced patient care and improved surgical training opportunities. However, establishing a workforce of independent/semi-independent practitioners who compete for the same training opportunities as surgeons in training may threaten the UK surgical training system, and therefore the care of our future patients.

  17. Recommendations for the use of PET imaging biomarkers in the diagnosis of neurodegenerative conditions associated with dementia: SEMNIM and SEN consensus.

    PubMed

    Arbizu, Javier; García-Ribas, Guillermo; Carrió, Ignasi; Garrastachu, Puy; Martínez-Lage, Pablo; Molinuevo, José Luis

    2015-01-01

    The new diagnostic criteria for Alzheimer's disease (AD) acknowledges the interest given to biomarkers to improve the specificity in subjects with dementia and to facilitate an early diagnosis of the pathophysiological process of AD in the prodromal or pre-dementia stage. The current availability of PET imaging biomarkers of synaptic dysfunction (PET-FDG) and beta amyloid deposition using amyloid-PET provides clinicians with the opportunity to apply the new criteria and improve diagnostic accuracy in their clinical practice. Therefore, it seems essential for the scientific societies involved to use the new clinical diagnostic support tools to establish clear, evidence-based and agreed set of recommendations for their appropriate use. The present work includes a systematic review of the literature on the utility of FDG-PET and amyloid-PET for the diagnosis of AD and related neurodegenerative diseases that occur with dementia. Thus, we propose a series of recommendations agreed on by the Spanish Society of Nuclear Medicine and Spanish Society of Neurology as a consensus statement on the appropriate use of PET imaging biomarkers.

  18. Psychological Treatments and Psychotherapies in the Neurorehabilitation of Pain: Evidences and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation

    PubMed Central

    Castelnuovo, Gianluca; Giusti, Emanuele M.; Manzoni, Gian Mauro; Saviola, Donatella; Gatti, Arianna; Gabrielli, Samantha; Lacerenza, Marco; Pietrabissa, Giada; Cattivelli, Roberto; Spatola, Chiara A. M.; Corti, Stefania; Novelli, Margherita; Villa, Valentina; Cottini, Andrea; Lai, Carlo; Pagnini, Francesco; Castelli, Lorys; Tavola, Mario; Torta, Riccardo; Arreghini, Marco; Zanini, Loredana; Brunani, Amelia; Capodaglio, Paolo; D'Aniello, Guido E.; Scarpina, Federica; Brioschi, Andrea; Priano, Lorenzo; Mauro, Alessandro; Riva, Giuseppe; Repetto, Claudia; Regalia, Camillo; Molinari, Enrico; Notaro, Paolo; Paolucci, Stefano; Sandrini, Giorgio; Simpson, Susan G.; Wiederhold, Brenda; Tamburin, Stefano

    2016-01-01

    Background: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams. Objectives: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases. Methods: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions. Results: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive—Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post—Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes

  19. Good practice recommendations for paediatric outpatient parenteral antibiotic therapy (p-OPAT) in the UK: a consensus statement.

    PubMed

    Patel, Sanjay; Abrahamson, Ed; Goldring, Stephen; Green, Helen; Wickens, Hayley; Laundy, Matt

    2015-02-01

    There is compelling evidence to support the rationale for managing children on intravenous antimicrobial therapy at home whenever possible, including parent and patient satisfaction, psychological well-being, return to school/employment, reductions in healthcare-associated infection and cost savings. As a joint collaboration between the BSAC and the British Paediatric Allergy, Immunity and Infection Group, we have developed good practice recommendations to highlight good clinical practice and governance within paediatric outpatient parenteral antibiotic therapy (p-OPAT) services across the UK. These guidelines provide a practical approach for safely delivering a p-OPAT service in both secondary care and tertiary care settings, in terms of the roles and responsibilities of members of the p-OPAT team, the structure required to deliver the service, identifying patients and pathologies that are suitable for p-OPAT, ensuring appropriate vascular access, antimicrobial choice and delivery and the clinical governance aspects of delivering a p-OPAT service. The process of writing a business case to support the introduction of a p-OPAT service is also addressed.

  20. Global Aesthetics Consensus: Hyaluronic Acid Fillers and Botulinum Toxin Type A—Recommendations for Combined Treatment and Optimizing Outcomes in Diverse Patient Populations

    PubMed Central

    Liew, Steven; Signorini, Massimo; Vieira Braz, André; Fagien, Steven; Swift, Arthur; De Boulle, Koenraad L.; Raspaldo, Hervé; Trindade de Almeida, Ada R.; Monheit, Gary

    2016-01-01

    Background: Combination of fillers and botulinum toxin for aesthetic applications is increasingly popular. Patient demographics continue to diversify, and include an expanding population receiving maintenance treatments over decades. Methods: A multinational panel of plastic surgeons and dermatologists convened the Global Aesthetics Consensus Group to develop updated guidelines with a worldwide perspective for hyaluronic acid fillers and botulinum toxin. This publication considers strategies for combined treatments, and how patient diversity influences treatment planning and outcomes. Results: Global Aesthetics Consensus Group recommendations reflect increased use of combined treatments in the lower and upper face, and some midface regions. A fully patient-tailored approach considers physiologic and chronologic age, ethnically associated facial morphotypes, and aesthetic ideals based on sex and culture. Lower toxin dosing, to modulate rather than paralyze muscles, is indicated where volume deficits influence muscular activity. Combination of toxin with fillers is appropriate for several indications addressed previously with toxin alone. New scientific data regarding hyaluronic acid fillers foster an evidence-based approach to selection of products and injection techniques. Focus on aesthetic units, rather than isolated rhytides, optimizes results from toxin and fillers. It also informs longitudinal treatment planning, and analysis of toxin nonresponders. Conclusions: The emerging objective of injectable treatment is facial harmonization rather than rejuvenation. Combined treatment is now a standard of care. Its use will increase further as we refine the concept that aspects of aging are intimately related, and that successful treatment entails identifying and addressing the primary causes of each. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V. PMID:27119917

  1. The International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care: a list of recommendations and additional conclusions: a statement for healthcare professionals from the Neurocritical Care Society and the European Society of Intensive Care Medicine.

    PubMed

    Le Roux, Peter; Menon, David K; Citerio, Giuseppe; Vespa, Paul; Bader, Mary Kay; Brophy, Gretchen; Diringer, Michael N; Stocchetti, Nino; Videtta, Walter; Armonda, Rocco; Badjatia, Neeraj; Bösel, Julian; Chesnut, Randall; Chou, Sherry; Claassen, Jan; Czosnyka, Marek; De Georgia, Michael; Figaji, Anthony; Fugate, Jennifer; Helbok, Raimund; Horowitz, David; Hutchinson, Peter; Kumar, Monisha; McNett, Molly; Miller, Chad; Naidech, Andrew; Oddo, Mauro; Olson, DaiWai; O'Phelan, Kristine; Provencio, J Javier; Puppo, Corinna; Riker, Richard; Roberson, Claudia; Schmidt, Michael; Taccone, Fabio

    2014-12-01

    Careful patient monitoring using a variety of techniques including clinical and laboratory evaluation, bedside physiological monitoring with continuous or non-continuous techniques and imaging is fundamental to the care of patients who require neurocritical care. How best to perform and use bedside monitoring is still being elucidated. To create a basic platform for care and a foundation for further research the Neurocritical Care Society in collaboration with the European Society of Intensive Care Medicine, the Society for Critical Care Medicine and the Latin America Brain Injury Consortium organized an international, multidisciplinary consensus conference to develop recommendations about physiologic bedside monitoring. This supplement contains a Consensus Summary Statement with recommendations and individual topic reviews as a background to the recommendations. In this article, we highlight the recommendations and provide additional conclusions as an aid to the reader and to facilitate bedside care.

  2. Current treatment and future prospects for the management of acute coronary syndromes: consensus recommendations of the 1997 ushuaia conference, tierra del fuego, Argentina.

    PubMed

    Gurfinkel, E

    1998-01-01

    Management of acute coronary syndromes, particularly unstable angina, acute myocardial infarction and non-Q-wave myocardial infarction, is one of the most common and costly problems facing modern medicine. Furthermore, the increasing availability of new research and clinical information relevant to the treatment of these conditions means that continuing reappraisal of management strategies is necessary. Accordingly, the Ushuaia conference, Tierra Del Fuego, Argentina, was convened to discuss current approaches and future treatment prospects for patients with these conditions. The conference was comprised of leading Argentinian cardiologists whose primary aim was to formulate consensus recommendations regarding the management of patients with acute coronary syndromes. The first of the major recommendations for the pharmacological management of acute coronary syndromes arising from the Ushuaia Consensus Conference was that aspirin (200 to 500mg initially, then 100 to 325 mg/day) should be administered to all patients except those for whom aspirin is absolutely (or relatively, depending on the clinician's discretion) contraindicated. In such cases, ticlopidine is a suitable alternative. Intravenous nitrates are indicated for patients with angina pain (24 to 48 hours' duration), ECG changes, recurrence of angina, or signs of heart failure; in other cases, oral, transdermal or sublingual nitrates may be administered. Use of beta-blockers is recommended except when absolutely contraindicated or when there is a strong suspicion of vasospasm as a dominant mechanism in angina. Intravenous administration of these agents is preferred in patients with tachycardia, arterial hypertension or angina. Calcium antagonists are generally not recommended as first choice therapy, but can be indicated (preferably using agents that decrease heart rate) when beta-blockers are contraindicated or when there is a strong suspicion of vasospasm as a dominant mechanism in angina. Calcium

  3. A new determination of the Geneva photometric passbands and their absolute calibration

    NASA Astrophysics Data System (ADS)

    Rufener, F.; Nicolet, B.

    The consensus regarding the absolute calibrations of the spectra of alpha Lyr and subdwarfs provoked a revision of the calibration of the Geneva photometric system passbands. The alterations made to the earlier version by Rufener and Maeder (1971) are smaller than plus or minus -5 percent. The new response functions are presented in tabular form for an equiphotonic flux. An absolute spectrophotometric adjustment allows to obtain for each entry of the Geneva catalog (28,000 stars) a corresponding spectrophotometric description in SI units. The definition and the means of computing the necessary quasi-isophotal frequencies or wavelengths are given. The coherence of the Geneva catalog with several sets of absolute spectrophotometric data is examined. A correction for the entire Gunn and Stryker (1983) catalog is proposed.

  4. The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology.

    PubMed

    Darragh, Teresa M; Colgan, Terence J; Cox, J Thomas; Heller, Debra S; Henry, Michael R; Luff, Ronald D; McCalmont, Timothy; Nayar, Ritu; Palefsky, Joel M; Stoler, Mark H; Wilkinson, Edward J; Zaino, Richard J; Wilbur, David C

    2012-07-01

    The terminology for human papillomavirus (HPV)-associated squamous lesions of the lower anogenital tract has a long history marked by disparate diagnostic terms derived from multiple specialties. It often does not reflect current knowledge of HPV biology and pathogenesis. A consensus process was convened to recommend terminology unified across lower anogenital sites. The goal was to create a histopathologic nomenclature system that reflects current knowledge of HPV biology, optimally uses available biomarkers, and facilitates clear communication across different medical specialties. The Lower Anogenital Squamous Terminology (LAST) Project was cosponsored by the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology and included 5 working groups; 3 work groups performed comprehensive literature reviews and developed draft recommendations. Another work group provided the historical background and the fifth will continue to foster implementation of the LAST recommendations. After an open comment period, the draft recommendations were presented at a consensus conference attended by LAST work group members, advisors, and representatives from 35 stakeholder organizations including professional societies and government agencies. Recommendations were finalized and voted on at the consensus meeting. The final, approved recommendations standardize biologically relevant histopathologic terminology for HPV-associated squamous intraepithelial lesions and superficially invasive squamous carcinomas across all lower anogenital tract sites and detail the appropriate use of specific biomarkers to clarify histologic interpretations and enhance diagnostic accuracy. A plan for disseminating and monitoring recommendation implementation in the practicing community was also developed. The implemented recommendations will facilitate communication between pathologists and their clinical colleagues and improve accuracy of histologic diagnosis with the

  5. The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology.

    PubMed

    Darragh, Teresa M; Colgan, Terence J; Cox, J Thomas; Heller, Debra S; Henry, Michael R; Luff, Ronald D; McCalmont, Timothy; Nayar, Ritu; Palefsky, Joel M; Stoler, Mark H; Wilkinson, Edward J; Zaino, Richard J; Wilbur, David C

    2012-10-01

    The terminology for human papillomavirus(HPV)–associated squamous lesions of the lower anogenital tract has a long history marked by disparate diagnostic terms derived from multiple specialties. It often does not reflect current knowledge of HPV biology and pathogenesis. A consensus process was convened to recommend terminology unified across lower anogenital sites. The goal was to create a histopathologic nomenclature system that reflects current knowledge of HPV biology, optimally uses available biomarkers, and facilitates clear communication across different medical specialties. The Lower Anogenital Squamous Terminology (LAST) Project was co-sponsored by the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology and included 5 working groups; 3 work groups performed comprehensive literature reviews and developed draft recommendations. Another work group provided the historical background and the fifth will continue to foster implementation of the LAST recommendations. After an open comment period, the draft recommendations were presented at a consensus conference attended by LAST work group members, advisors, and representatives from 35 stakeholder organizations including professional societies and government agencies. Recommendations were finalized and voted on at the consensus meeting. The final, approved recommendations standardize biologically relevant histopathologic terminology for HPV-associated squamous intraepithelial lesions and superficially invasive squamous carcinomas across all lower anogenital tract sites and detail the appropriate use of specific biomarkers to clarify histologic interpretations and enhance diagnostic accuracy. A plan for disseminating and monitoring recommendation implementation in the practicing community was also developed. The implemented recommendations will facilitate communication between pathologists and their clinical colleagues and improve accuracy of histologic diagnosis with

  6. The Lower Anogenital Squamous Terminology Standardization project for HPV-associated lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology.

    PubMed

    Darragh, Teresa M; Colgan, Terence J; Thomas Cox, J; Heller, Debra S; Henry, Michael R; Luff, Ronald D; McCalmont, Timothy; Nayar, Ritu; Palefsky, Joel M; Stoler, Mark H; Wilkinson, Edward J; Zaino, Richard J; Wilbur, David C

    2013-01-01

    The terminology for human papillomavirus (HPV)-associated squamous lesions of the lower anogenital tract has a long history marked by disparate diagnostic terms derived from multiple specialties. It often does not reflect current knowledge of HPV biology and pathogenesis. A consensus process was convened to recommend terminology unified across lower anogenital sites. The goal was to create a histopathologic nomenclature system that reflects current knowledge of HPV biology, optimally uses available biomarkers, and facilitates clear communication across different medical specialties. The Lower Anogenital Squamous Terminology (LAST) project was co-sponsored by the College of American Pathologists (CAP) and the American Society for Colposcopy and Cervical Pathology (ASCCP) and included 5 working groups; three work groups performed comprehensive literature reviews and developed draft recommendations. Another work group provided the historical background and the fifth will continue to foster implementation of the LAST recommendations. After an open comment period, the draft recommendations were presented at a consensus conference attended by LAST work group members, advisors and representatives from 35 stakeholder organizations including professional societies and government agencies. Recommendations were finalized and voted upon at the consensus meeting. The final approved recommendations standardize biologically-relevant histopathologic terminology for HPV-associated squamous intraepithelial lesions and superficially invasive squamous carcinomas across all lower anogenital tract sites and detail appropriate use of specific biomarkers to clarify histologic interpretations and enhance diagnostic accuracy. A plan for disseminating and monitoring recommendation implementation in the practicing community was also developed. The implemented recommendations will facilitate communication between pathologists and their clinical colleagues and improve accuracy of histologic

  7. Unique characteristics of Geneva apple rootstocks

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Geneva® apple rootstock breeding program has been operating since the early 1970’s. It is a unique program in that it had access to important germplasm resources that later became the USDA ARS apple collection in Geneva, NY. This genetic diversity allowed for the achievement of one of the proj...

  8. WHO Working Group discussion on revision of the WHO recommendations for the production and control of poliomyelitis vaccines (oral): TRS Nos. 904 and 910. Report of Meeting held on 20-22 July 2010, Geneva, Switzerland.

    PubMed

    Martin, Javier; Milne, Catherine; Minor, Philip; Chumakov, Konstantin; Baca-Estrada, Maria; Caruana, Jacqueline Fournier; Zhou, Tiequn

    2011-09-02

    Oral poliomyelitis vaccine (OPV) is a critical part of the polio eradication programme. A high number of doses are administered each year with an impact on billions of citizens worldwide. It is therefore essential that written standards concerning OPV are up to date and widely available. The World Health Organization (WHO) publishes technical guidance on the quality, safety and efficacy of vaccines intended to assist national regulatory authorities (NRAs), national control laboratories (NCLs) and manufacturers. As part of its programme, on 20-22 July 2010 WHO convened a working group meeting to initiate the revision of the WHO recommendations on the production and control of OPV as presently outlined in the Technical Reports Series (TRS) issues Nos. 904 and 910 [1,2]. The attendees included experts from academia, NRAs/NCLs and industry involved in the study, manufacture, and authorization and testing/release of OPV from countries around the world including representatives from China, the European Union, Indonesia, Japan, Mexico, and the USA. The objective was to review the state of knowledge concerning production and control of OPV, with a focus on neurovirulence testing, to determine how the existing guidelines should be updated and what recommendations should be made for the future. The outcomes of this meeting will be taken into consideration in future revision of the WHO TRS.

  9. Using Consensus Groups in Online Learning

    ERIC Educational Resources Information Center

    Smith, Regina O.; Dirkx, John M.

    2007-01-01

    This chapter describes online consensus group work, a form of collaborative learning. It discusses collaborative learning, small group work, and consensus learning, with recommendations for their use in online contexts.

  10. Cancer, cigarette smoking and premature death in Europe: a review including the Recommendations of European Cancer Experts Consensus Meeting, Helsinki, October 1996.

    PubMed

    Boyle, P

    1997-05-01

    cause of adult death in the world. For men in developed countries, the full effects of smoking can already be seen. Tobacco now causes one-third of all male deaths in middle age (plus one fifth in old age). Tobacco is a cause of about half of all male cancer deaths in middle age (plus one-third in old age). Of those who start smoking in their teenage years and keep on smoking, about half will be killed by tobacco. Half of these deaths will be in middle age (35-69) and each will lose an average of 20-25 years of non-smoker life expectancy. In non-smokers in many countries, cancer mortality is decreasing slowly and total mortality rapidly. The war against cancer is being won slowly: the effects of cigarette smoking are holding back this victory. Lung cancer now kills more women in the United States each year than breast cancer. For women in developed countries, the peak of the tobacco epidemic has not yet arrived. Tobacco now causes almost one-third of all deaths in women in middle age in the United States. Although it has only 5% of the world's female population, the United States has 50% of the world's deaths from smoking in women. Tobacco smoking is a major cause of premature death. Throughout Europe, in 1990 tobacco smoking caused three quarters of a million deaths in middle age (between 35 and 69). In the Member States of the European Union in 1990 there were over one quarter of a million deaths in middle age directly caused by tobacco smoking: there were 219700 in men and 31900 in women. There were many more deaths caused by tobacco at older ages. In countries of central and eastern Europe, including the former USSR, there were 441200 deaths in middle age in men and 42100 deaths in women. There is a need for urgent action to help contain this important and unnecessary loss of life. In formulating Recommendations, the European Cancer Experts Consensus Committee recognised that Tobacco Control depends on various parts of society and not only on the individual.

  11. Neuropathic pain phenotyping by international consensus (NeuroPPIC) for genetic studies: a NeuPSIG systematic review, Delphi survey, and expert panel recommendations.

    PubMed

    van Hecke, Oliver; Kamerman, Peter R; Attal, Nadine; Baron, Ralf; Bjornsdottir, Gyda; Bennett, David L H; Bennett, Michael I; Bouhassira, Didier; Diatchenko, Luda; Freeman, Roy; Freynhagen, Rainer; Haanpää, Maija; Jensen, Troels S; Raja, Srinivasa N; Rice, Andrew S C; Seltzer, Zeʼev; Thorgeirsson, Thorgeir E; Yarnitsky, David; Smith, Blair H

    2015-11-01

    For genetic research to contribute more fully to furthering our knowledge of neuropathic pain, we require an agreed, valid, and feasible approach to phenotyping, to allow collaboration and replication in samples of sufficient size. Results from genetic studies on neuropathic pain have been inconsistent and have met with replication difficulties, in part because of differences in phenotypes used for case ascertainment. Because there is no consensus on the nature of these phenotypes, nor on the methods of collecting them, this study aimed to provide guidelines on collecting and reporting phenotypes in cases and controls for genetic studies. Consensus was achieved through a staged approach: (1) systematic literature review to identify all neuropathic pain phenotypes used in previous genetic studies; (2) Delphi survey to identify the most useful neuropathic pain phenotypes and their validity and feasibility; and (3) meeting of experts to reach consensus on the optimal phenotype(s) to be collected from patients with neuropathic pain for genetic studies. A basic "entry level" set of phenotypes was identified for any genetic study of neuropathic pain. This set identifies cases of "possible" neuropathic pain, and controls, and includes: (1) a validated symptom-based questionnaire to determine whether any pain is likely to be neuropathic; (2) body chart or checklist to identify whether the area of pain distribution is neuroanatomically logical; and (3) details of pain history (intensity, duration, any formal diagnosis). This NeuroPPIC "entry level" set of phenotypes can be expanded by more extensive and specific measures, as determined by scientific requirements and resource availability.

  12. Evidence-based nutritional recommendations for the prevention and treatment of overweight and obesity in adults (FESNAD-SEEDO consensus document). The role of diet in obesity prevention (II/III).

    PubMed

    Gargallo Fernández, M; Quiles Izquierdo, J; Basulto Marset, J; Breton Lesmes, I; Formiguera Sala, X; Salas-Salvadó, J

    2012-01-01

    This study is a consensus document of two Spanish scientific associations, FESNAD (Spanish Federation of Nutrition, Food and Dietetetic Associations) and SEEDO (Spanish Association for the Study of Obesity), about the role of the diet in the prevention and of overweight and obesity in adults. It is the result of a careful and systematic review of the data published in the medical literature from January 1st 1996 to January 31st 2011 concerning the role of the diet on obesity prevention. The conclusions obtained have been classified according several evidence levels. Subsequently, in agreement with these evidence levels, different degree recommendations are established. These recommendations could be potentially useful to design food guides as part of strategies to prevent overweight and obesity.

  13. [Recommendations for radiological diagnosis and assessment of treatment response in lung cancer: a national consensus statement by the Spanish Society of Medical Radiology and the Spanish Society of Medical Oncology].

    PubMed

    Ferreirós, J; Cabeza, B; Gayete, Á; Sánchez, M; Torres, M I; Cobo, M; Isla, D; Puente, J; Reguart, N; de Castro, J

    2015-01-01

    The last decade has seen substantial progress in the diagnostic and therapeutic approach to lung cancer, thus meaning that its prognosis has improved. The Spanish Society of Medical Radiology (SERAM) and the Spanish Society of Medical Oncology (SEOM) have therefore produced a national consensus statement in order to make recommendations for radiological diagnosis and assessment of treatment response in patients with lung cancer. This expert group recommends multi-detector computed tomography (MDCT) as the technique of choice for investigating this disease. The radiology report should include a full assessment by the TNM staging system. Lastly, when the patient is on immunotherapy, response evaluation should employ not only Response Evaluation Criteria in Solid Tumours (RECIST 1.1) but also Immune-Related Response Criteria (irRC).

  14. Breast cancer and primary systemic therapy. Results of the Consensus Meeting on the recommendations for pathological examination and histological report of breast cancer specimens in the Marche Region.

    PubMed

    Santinelli, A; De Nictolis, M; Mambelli, V; Ranaldi, R; Bearzi, I; Battellpi, N; Mariotti, C; Fabbietti, L; Baldassarre, S; Giuseppetti, G M; Fabris, G

    2011-10-01

    Primary systemic therapy (PST) adds some practical problems to the pathologic examination of neoplastic breast tissue obtained from patients before and after chemotherapy. Pathologists, oncologists, breast surgeons, radiotherapists and radiologists in the Marche Region held a Consensus Meeting in Ancona on May 13, 2010, in which 15 statements dealing with neoadjuvant chemotherapy were approved by all participants. The first two statements are related to the pre-PST phase and concern the technical procedures and the histological report of the core biopsy. The other statements deal with similar issues of the post-PST surgical specimen.

  15. [Safe prescription recommendations for non steroidal anti-inflammatory drugs: Consensus document ellaborated by nominated experts of three scientific associations (SER-SEC-AEG)].

    PubMed

    Lanas, Angel; Benito, Pere; Alonso, Joaquín; Hernández-Cruz, Blanca; Barón-Esquivias, Gonzalo; Perez-Aísa, Angeles; Calvet, Xavier; García-Llorente, José Francisco; Gobbo, Milena; Gonzalez-Juanatey, José R

    2014-03-01

    This article outlines key recommendations for the appropriate prescription of non steroidal anti-inflammatory drugs to patients with different musculoskeletal problems. These recommendations are based on current scientific evidence, and takes into consideration gastrointestinal and cardiovascular safety issues. The recommendations have been agreed on by experts from three scientific societies (Spanish Society of Rheumatology [SER], Spanish Association of Gastroenterology [AEG] and Spanish Society of Cardiology [SEC]), following a two-round Delphi methodology. Areas that have been taken into account encompass: efficiency, cardiovascular risk, gastrointestinal risk, liver risk, renal risk, inflammatory bowel disease, anemia, post-operative pain, and prevention strategies. We propose a patient management algorithm that summarizes the main aspects of the recommendations.

  16. International recommendation for a comprehensive neuropathologic workup of epilepsy surgery brain tissue: A consensus Task Force report from the ILAE Commission on Diagnostic Methods.

    PubMed

    Blümcke, Ingmar; Aronica, Eleonora; Miyata, Hajime; Sarnat, Harvey B; Thom, Maria; Roessler, Karl; Rydenhag, Bertil; Jehi, Lara; Krsek, Pavel; Wiebe, Samuel; Spreafico, Roberto

    2016-03-01

    Epilepsy surgery is an effective treatment in many patients with drug-resistant focal epilepsies. An early decision for surgical therapy is facilitated by a magnetic resonance imaging (MRI)-visible brain lesion congruent with the electrophysiologically abnormal brain region. Recent advances in the pathologic diagnosis and classification of epileptogenic brain lesions are helpful for clinical correlation, outcome stratification, and patient management. However, application of international consensus classification systems to common epileptic pathologies (e.g., focal cortical dysplasia [FCD] and hippocampal sclerosis [HS]) necessitates standardized protocols for neuropathologic workup of epilepsy surgery specimens. To this end, the Task Force of Neuropathology from the International League Against Epilepsy (ILAE) Commission on Diagnostic Methods developed a consensus standard operational procedure for tissue inspection, distribution, and processing. The aims are to provide a systematic framework for histopathologic workup, meeting minimal standards and maximizing current and future opportunities for morphofunctional correlations and molecular studies for both clinical care and research. Whenever feasible, anatomically intact surgical specimens are desirable to enable systematic analysis in selective hippocampectomies, temporal lobe resections, and lesional or nonlesional neocortical samples. Correct orientation of sample and the sample's relation to neurophysiologically aberrant sites requires good communication between pathology and neurosurgical teams. Systematic tissue sampling of 5-mm slabs along a defined anatomic axis and application of a limited immunohistochemical panel will ensure a reliable differential diagnosis of main pathologies encountered in epilepsy surgery.

  17. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management.

    PubMed

    Misra, A; Chowbey, P; Makkar, B M; Vikram, N K; Wasir, J S; Chadha, D; Joshi, Shashank R; Sadikot, S; Gupta, R; Gulati, Seema; Munjal, Y P

    2009-02-01

    Asian Indians exhibit unique features of obesity; excess body fat, abdominal adiposity, increased subcutaneous and intra-abdominal fat, and deposition of fat in ectopic sites (liver, muscle, etc.). Obesity is a major driver for the widely prevalent metabolic syndrome and type 2 diabetes mellitus (T2DM) in Asian Indians in India and those residing in other countries. Based on percentage body fat and morbidity data, limits of normal BMI are narrower and lower in Asian Indians than in white Caucasians. In this consensus statement, we present revised guidelines for diagnosis of obesity, abdominal obesity, the metabolic syndrome, physical activity, and drug therapy and bariatric surgery for obesity in Asian Indians after consultations with experts from various regions of India belonging to the following medical disciplines; internal medicine, metabolic diseases, endocrinology, nutrition, cardiology, exercise physiology, sports medicine and bariatric surgery, and representing reputed medical institutions, hospitals, government funded research institutions, and policy making bodies. It is estimated that by application of these guidelines, additional 10-15% of Indian population would be labeled as overweight/obese and would require appropriate management. Application of these guidelines on countrywide basis is also likely to have a deceleration effect on the escalating problem of T2DM and cardiovascular disease. These guidelines could be revised in future as appropriate, after another large and countrywide consensus process. Till that time, these should be used by clinicians, researchers and policymakers dealing with obesity and related diseases.

  18. Evidence-based recommendations for negative pressure wound therapy: treatment variables (pressure levels, wound filler and contact layer)--steps towards an international consensus.

    PubMed

    Birke-Sorensen, H; Malmsjo, M; Rome, P; Hudson, D; Krug, E; Berg, L; Bruhin, A; Caravaggi, C; Chariker, M; Depoorter, M; Dowsett, C; Dunn, R; Duteille, F; Ferreira, F; Francos Martínez, J M; Grudzien, G; Ichioka, S; Ingemansson, R; Jeffery, S; Lee, C; Vig, S; Runkel, N; Martin, R; Smith, J

    2011-09-01

    Negative pressure wound therapy (NPWT) is becoming a commonplace treatment in many clinical settings. New devices and dressings are being introduced. Despite widespread adoption, there remains uncertainty regarding several aspects of NPWT use. To respond to these gaps, a global expert panel was convened to develop evidence-based recommendations describing the use of NPWT. In a previous communication, we have reviewed the evidence base for the use of NPWT within trauma and reconstructive surgery. In this communication, we present results of the assessment of evidence relating to the different NPWT treatment variables: different wound fillers (principally foam and gauze); when to use a wound contact layer; different pressure settings; and the impact of NPWT on bacterial bioburden. Evidence-based recommendations were obtained by a systematic review of the literature, grading of evidence and drafting of the recommendations by a global expert panel. Evidence and recommendations were graded according to the Scottish Intercollegiate Guidelines Network (SIGN) classification system. In general, there is relatively weak evidence on which to base recommendations for any one NPWT treatment variable over another. Overall, 14 recommendations were developed: five for the choice of wound filler and wound contact layer, four for choice of pressure setting and five for use of NPWT in infected wounds. With respect to bioburden, evidence suggests that reduction of bacteria in wounds is not a major mode of action of NPWT.

  19. Geneva Smitherman: Translingualist, Code-Mesher, Activist

    ERIC Educational Resources Information Center

    Durst, Russel K.

    2014-01-01

    This article examines the work of Geneva Smitherman, its contribution to the development of composition studies, and its relation to recent scholarship on translingualism and code-meshing. Analyzing her prodigious output in relation to these contemporary studies of language diversity and writing instruction, the article considers Smitherman's…

  20. [Recommendations for the management of pancreatic cancer type adenocarcinoma: A consensus statement reached during the 2015 Latin American Symposium on Gastroenterological Oncology].

    PubMed

    Caglevic, Christian; Gallardo, Jorge; de la Torre, Marcela; Mahave, Mauricio; Müller, Bettina; Solé, Sebastián; Moscoso, Yuri; De La Fuente, Hernán; Roa, Juan Carlos; Hoefler, Sebastián; Butte, Jean M; González M, Pablo; O'Connor, Juan Manuel; Torres, Javiera; Pérez Encalada, Verónica; Alarcón Cano, Daniel; Ubillos, Luis; Rolfo, Christian; Lingua, Alejo; Díaz Romero, Consuelo; Padilla Rosciano, Alejandro; Cuartero, Viviana; Calderillo Ruiz, Germán; Schwartsmann, Gilberto; Kon Jara, Xavier; Andrade G, Andrés; Mas López, Luis; Barajas, Olga; Carballido, Marcela; Lembach, Hanns; Morillas G, Lena; Roca, Enrique; Lobatón, José; Montenegro B, Paola; Yepes, Andrés; Marsiglia, Hugo

    2016-10-01

    Pancreatic cancer is a malignancy of great impact in developed countries and is having an increasing impact in Latin America. Incidence and mortality rates are similar for this cancer. This is an important reason to offer to the patients the best treatments available. During the Latin American Symposium of Gastroenterology Oncology (SLAGO) held in Viña del Mar, Chile, in April 2015, a multidisciplinary group of specialists in the field met to discuss about this disease. The main conclusions of this meeting, where practitioners from most of Latin American countries participated, are listed in this consensus that seek to serve as a guide for better decision making for patients with pancreatic cancer in Latin America.

  1. Quality indicators for the management of Barrett's esophagus, dysplasia, and esophageal adenocarcinoma: international consensus recommendations from the American Gastroenterological Association Symposium.

    PubMed

    Sharma, Prateek; Katzka, David A; Gupta, Neil; Ajani, Jaffer; Buttar, Navtej; Chak, Amitabh; Corley, Douglas; El-Serag, Hashem; Falk, Gary W; Fitzgerald, Rebecca; Goldblum, John; Gress, Frank; Ilson, David H; Inadomi, John M; Kuipers, Ernest J; Lynch, John P; McKeon, Frank; Metz, David; Pasricha, Pankaj J; Pech, Oliver; Peek, Richard; Peters, Jeffrey H; Repici, Alessandro; Seewald, Stefan; Shaheen, Nicholas J; Souza, Rhonda F; Spechler, Stuart J; Vennalaganti, Prashanth; Wang, Kenneth

    2015-11-01

    The development of and adherence to quality indicators in gastroenterology, as in all of medicine, is increasing in importance to ensure that patients receive consistent high-quality care. In addition, government-based and private insurers will be expecting documentation of the parameters by which we measure quality, which will likely affect reimbursements. Barrett's esophagus remains a particularly important disease entity for which we should maintain up-to-date guidelines, given its commonality, potentially lethal outcomes, and controversies regarding screening and surveillance. To achieve this goal, a relatively large group of international experts was assembled and, using the modified Delphi method, evaluated the validity of multiple candidate quality indicators for the diagnosis and management of Barrett's esophagus. Several candidate quality indicators achieved >80% agreement. These statements are intended to serve as a consensus on candidate quality indicators for those who treat patients with Barrett's esophagus.

  2. Consensus statement of the academy of nutrition and dietetics/american society for parenteral and enteral nutrition: Characteristics recommended for the identification and documentation of adult malnutrition (undernutrition)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) recommend that a standardized set of diagnostic characteristics be used to identify and document adult malnutrition in routine clinical practice. An etiologically based diagno...

  3. Consensus report on the radiological management of patients with gastrointestinal stromal tumours (GIST): recommendations of the German GIST Imaging Working Group.

    PubMed

    Kalkmann, Janine; Zeile, Martin; Antoch, Gerald; Berger, Frank; Diederich, Stefan; Dinter, Dietmar; Fink, Christian; Janka, Rolf; Stattaus, Jörg

    2012-05-07

    The aim was to reach consensus in imaging for staging and follow-up as well as for therapy response assessment in patients with gastrointestinal stromal tumours (GIST). The German GIST Imaging Working Group was formed by 9 radiologists engaged in assessing patients with GIST treated with targeted therapy. The following topics were discussed: indication and optimal acquisition techniques of computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET)/CT; tumour response assessment considering response criteria and measurement techniques on CT, MRI and PET/CT; result interpretation; staging interval and pitfalls. Contrast-enhanced CT is the standard method for GIST imaging. MRI is the method of choice in case of liver-specific questions or contraindications to CT. PET/CT should be used for early response assessment or inconclusive results on morphologic imaging. All imaging techniques should be standardized allowing a reliable response assessment. Response has to be assessed with respect to lesion size, lesion density and appearance of new lesions. A critical issue is pseudoprogression due to myxoid degeneration or intratumoural haemorrhage. The management of patients with GIST receiving a targeted therapy requires a standardized algorithm for imaging and an appropriate response assessment with respect to changes in lesion size and density.

  4. Standards and Guidelines for the Interpretation of Sequence Variants: A Joint Consensus Recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology

    PubMed Central

    Richards, Sue; Aziz, Nazneen; Bale, Sherri; Bick, David; Das, Soma; Gastier-Foster, Julie; Grody, Wayne W.; Hegde, Madhuri; Lyon, Elaine; Spector, Elaine; Voelkerding, Karl; Rehm, Heidi L.

    2015-01-01

    The American College of Medical Genetics and Genomics (ACMG) previously developed guidance for the interpretation of sequence variants.1 In the past decade, sequencing technology has evolved rapidly with the advent of high-throughput next generation sequencing. By adopting and leveraging next generation sequencing, clinical laboratories are now performing an ever increasing catalogue of genetic testing spanning genotyping, single genes, gene panels, exomes, genomes, transcriptomes and epigenetic assays for genetic disorders. By virtue of increased complexity, this paradigm shift in genetic testing has been accompanied by new challenges in sequence interpretation. In this context, the ACMG convened a workgroup in 2013 comprised of representatives from the ACMG, the Association for Molecular Pathology (AMP) and the College of American Pathologists (CAP) to revisit and revise the standards and guidelines for the interpretation of sequence variants. The group consisted of clinical laboratory directors and clinicians. This report represents expert opinion of the workgroup with input from ACMG, AMP and CAP stakeholders. These recommendations primarily apply to the breadth of genetic tests used in clinical laboratories including genotyping, single genes, panels, exomes and genomes. This report recommends the use of specific standard terminology: ‘pathogenic’, ‘likely pathogenic’, ‘uncertain significance’, ‘likely benign’, and ‘benign’ to describe variants identified in Mendelian disorders. Moreover, this recommendation describes a process for classification of variants into these five categories based on criteria using typical types of variant evidence (e.g. population data, computational data, functional data, segregation data, etc.). Because of the increased complexity of analysis and interpretation of clinical genetic testing described in this report, the ACMG strongly recommends that clinical molecular genetic testing should be performed in a CLIA

  5. Recommendations for Solid Organ Transplantation for Transplant Candidates With a Pretransplant Diagnosis of Cutaneous Squamous Cell Carcinoma, Merkel Cell Carcinoma and Melanoma: A Consensus Opinion From the International Transplant Skin Cancer Collaborative (ITSCC).

    PubMed

    Zwald, F; Leitenberger, J; Zeitouni, N; Soon, S; Brewer, J; Arron, S; Bordeaux, J; Chung, C; Abdelmalek, M; Billingsley, E; Vidimos, A; Stasko, T

    2016-02-01

    Advancements in solid organ transplantation successfully extend the lives of thousands of patients annually. The tenet of organ stewardship aims to prevent the futile expenditure of scarce donor organs in patient populations with high mortality risk, to the detriment of potential recipients with greater predicted life expectancy. The development of skin cancer posttransplantation portends tremendous morbidity, adversely affecting quality of life for many transplant recipients. This special article, provided by of members of the International Transplant Skin Cancer Collaborative (ITSCC), will provide the transplant professional with a consensus opinion and recommendations as to an appropriate wait period pretransplantation for transplant candidates with a history of either cutaneous squamous cell carcinoma, malignant melanoma, or Merkel cell carcinoma.

  6. The role of gender, psycho-social factors and anthropological-cultural dimensions on pain in neurorehabilitation. Evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation.

    PubMed

    Aloisi, Anna M; Berlincioni, Vanna; Torta, Riccardo; Nappi, Rossella E; Tassorelli, Cristina; Barale, Francesco; Ieraci, Valentina; Giusti, Emanuele M; Pietrabissa, Giada; Tamburin, Stefano; Manzoni, Gian M; Castelnuovo, Gianluca

    2016-10-01

    Pain is frequent in patients undergoing neurorehabilitation, but there is a number of still unanswered questions on this topic. The Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) was constituted with the purpose to identify the best practices that can be used in this context. In this article we summarize the existing evidence and recommendations provided by the ICCPN about the role of gender, psycho-social factors and anthropological-cultural dimensions on pain in neurorehabilitation. Sex, gender, psycho-social variables, anthropological and cultural features may influence pain expression, and its pharmacological and non-pharmacological outcome, but the role of these factors has not been consistently explored in neurorehabilitation. There is a number of psychological factors that can be correlated with or represent a predictor for pain, or may influence the treatment and outcome of neurorehabilitation programs. All these factors should be considered when designing these programs, and future studies should incorporate them as potential covariates that may influence outcome.

  7. The design of phase II clinical trials testing cancer therapeutics: consensus recommendations from the clinical trial design task force of the national cancer institute investigational drug steering committee.

    PubMed

    Seymour, Lesley; Ivy, S Percy; Sargent, Daniel; Spriggs, David; Baker, Laurence; Rubinstein, Larry; Ratain, Mark J; Le Blanc, Michael; Stewart, David; Crowley, John; Groshen, Susan; Humphrey, Jeffrey S; West, Pamela; Berry, Donald

    2010-03-15

    The optimal design of phase II studies continues to be the subject of vigorous debate, especially studies of newer molecularly targeted agents. The observations that many new therapeutics "fail" in definitive phase III studies, coupled with the numbers of new agents to be tested as well as the increasing costs and complexity of clinical trials, further emphasize the critical importance of robust and efficient phase II design. The Clinical Trial Design Task Force (CTD-TF) of the National Cancer Institute (NCI) Investigational Drug Steering Committee (IDSC) has published a series of discussion papers on phase II trial design in Clinical Cancer Research. The IDSC has developed formal recommendations about aspects of phase II trial design that are the subject of frequent debate, such as endpoints (response versus progression-free survival), randomization (single-arm designs versus randomization), inclusion of biomarkers, biomarker-based patient enrichment strategies, and statistical design (e.g., two-stage designs versus multiple-group adaptive designs). Although these recommendations in general encourage the use of progression-free survival as the primary endpoint, randomization, inclusion of biomarkers, and incorporation of newer designs, we acknowledge that objective response as an endpoint and single-arm designs remain relevant in certain situations. The design of any clinical trial should always be carefully evaluated and justified based on characteristic specific to the situation.

  8. Quality criteria in bariatric surgery: Consensus review and recommendations of the Spanish Association of Surgeons and the Spanish Society of Bariatric Surgery.

    PubMed

    Sabench Pereferrer, Fátima; Domínguez-Adame Lanuza, Eduardo; Ibarzabal, Ainitze; Socas Macias, María; Valentí Azcárate, Víctor; García Ruiz de Gordejuela, Amador; García-Moreno Nisa, Francisca; González Fernández, Jesús; Vilallonga Puy, Ramón; Vilarrasa García, Nuria; Sánchez Santos, Raquel

    2017-01-01

    Bariatric surgery has proven to be highly effective in controlling obesity and metabolic syndrome; the results of this surgery are not only expressed in terms of weight loss, but also in terms of resolution of comorbidities, improved quality of life and complications. The different parameters used to measure these outcomes require uniformity and reference patterns. Therefore, it is essential to identify those indicators and quality criteria that are helpful in defining the «best practice» principles in bariatric surgery. In this regard, the Section of Obesity of the Spanish Association of Surgeons, in collaboration with the Spanish Society for Bariatric Surgery (SECO), present as an objective to identify the key points that define «quality» in this type of surgery. We describe the main indicators based on the published literature as well as the criteria for referral of the main comorbidities according to the evidence found and grades of recommendation.

  9. Guidelines for the provision of echocardiography in Canada: recommendations of a joint Canadian Cardiovascular Society/Canadian Society of Echocardiography Consensus Panel.

    PubMed

    Sanfilippo, Anthony J; Bewick, David; Chan, K L; Cujec, Bibiana; Dumesnil, J G; Honos, George; Munt, Brad; Sasson, Zion; Tam, James; Tomlinson, Charles; Aboguddah, Ayman; Ahmed, Shaheeda; Ali, Mohamed; Arsenault, Marie; Ascah, Kathryn; Ashton, Tom; Baird, Michael; Basmadjian, Arsene; Beique, Francois; Blakeley, Michael; Blais, Marie-Josee; Burggraf, Gary; Burwash, Ian; Cochrane, Jessica; Fagan, Susan; Giannoccaro, Peter; Hughes, William; Jones, Alan; Jue, John; Koilpillai, Chris; Leblanc, Marie-Helene; Londry, Colleen; Morgan, Dennis; O'Reilly, Michael; Sawchuk, Corey; Siu, Samuel; Sochowski, Randy; Tremblay, Guy; Welikovitch, Lisa; Yu, Eric

    2005-07-01

    Recognizing the central role of echocardiographic examinations in the assessment of most cardiac disorders and the need to ensure the provision of these services in a highly reliable, timely, economical and safe manner, the Canadian Cardiovascular Society and Canadian Society of Echocardiography undertook a comprehensive review of all aspects influencing the provision of echocardiographic services in Canada. Five regional panels were established to develop preliminary recommendations in the five component areas, which included the echocardiographic examination, the echocardiographic laboratory and report, the physician, the sonographer and indications for examinations. Membership in the panels was structured to recognize the regional professional diversity of individuals involved in the provision of echocardiography. In addition, a focus group of cardiac sonograhers was recruited to review aspects of the document impacting on sonographer responsibilities and qualification. The document is intended to be used as a comprehensive and practical reference for all of those involved in the provision of echocardiography in Canada.

  10. Belgian consensus recommendations for flow cytometric immunophenotyping. The Belgian Association for Cytometry/Belgische Vereniging voor Cytometrie/Association Belge de Cytométrie.

    PubMed

    Van Bockstaele, D R; Deneys, V; Philippé, J; Bernier, M; Kestens, L; Chatelain, B; De Waele, M; Demanet, C

    1999-04-01

    This paper summarises the guidelines and recommendations that were generated during a number of discussion forums attended by the majority of Belgian cytometry laboratory professionals. These forums focused on the rational and optimal use of flow cytometric evaluations in the clinical laboratory setting. The aim was to improve the coherence of the testing panels and the quality of the results and--as such--the clinical diagnostic information. It was also the aim to provide the Belgian prescribing physician and interested laymen with an updated overview of the flow cytometric possibilities. Emphasis is placed on immunophenotyping of haematological malignancies, hematopoietic progenitor cell counting and follow-up of the viral infection caused by the human immunodeficiency virus.

  11. Potential use of biomarkers in acute kidney injury: report and summary of recommendations from the 10th Acute Dialysis Quality Initiative consensus conference.

    PubMed

    Murray, Patrick T; Mehta, Ravindra L; Shaw, Andrew; Ronco, Claudio; Endre, Zoltan; Kellum, John A; Chawla, Lakhmir S; Cruz, Dinna; Ince, Can; Okusa, Mark D

    2014-03-01

    Over the last decade there has been considerable progress in the discovery and development of biomarkers of kidney disease, and several have now been evaluated in different clinical settings. Although there is a growing literature on the performance of various biomarkers in clinical studies, there is limited information on how these biomarkers would be utilized by clinicians to manage patients with acute kidney injury (AKI). Recognizing this gap in knowledge, we convened the 10th Acute Dialysis Quality Initiative meeting to review the literature on biomarkers in AKI and their application in clinical practice. We asked an international group of experts to assess four broad areas for biomarker utilization for AKI: risk assessment, diagnosis, and staging; differential diagnosis; prognosis and management; and novel physiological techniques including imaging. This article provides a summary of the key findings and recommendations of the group, to equip clinicians to effectively use biomarkers in AKI.

  12. Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition).

    PubMed

    White, Jane V; Guenter, Peggi; Jensen, Gordon; Malone, Ainsley; Schofield, Marsha

    2012-05-01

    The Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) recommend that a standardized set of diagnostic characteristics be used to identify and document adult malnutrition in routine clinical practice. An etiologically based diagnostic nomenclature that incorporates a current understanding of the role of the inflammatory response on malnutrition's incidence, progression, and resolution is proposed. Universal use of a single set of diagnostic characteristics will facilitate malnutrition's recognition, contribute to more valid estimates of its prevalence and incidence, guide interventions, and influence expected outcomes. This standardized approach will also help to more accurately predict the human and financial burdens and costs associated with malnutrition's prevention and treatment and further ensure the provision of high-quality, cost-effective nutrition care.

  13. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition).

    PubMed

    White, Jane V; Guenter, Peggi; Jensen, Gordon; Malone, Ainsley; Schofield, Marsha

    2012-05-01

    The Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) recommend that a standardized set of diagnostic characteristics be used to identify and document adult malnutrition in routine clinical practice. An etiologically based diagnostic nomenclature that incorporates a current understanding of the role of the inflammatory response on malnutrition's incidence, progression, and resolution is proposed. Universal use of a single set of diagnostic characteristics will facilitate malnutrition's recognition, contribute to more valid estimates of its prevalence and incidence, guide interventions, and influence expected outcomes. This standardized approach will also help to more accurately predict the human and financial burdens and costs associated with malnutrition's prevention and treatment, and further ensure the provision of high quality, cost effective nutritional care.

  14. Systematic Review of the Literature and Evidence-Based Recommendations for Antibiotic Prophylaxis in Trauma: Results from an Italian Consensus of Experts

    PubMed Central

    Poole, Daniele; Chieregato, Arturo; Langer, Martin; Viaggi, Bruno; Cingolani, Emiliano; Malacarne, Paolo; Mengoli, Francesca; Nardi, Giuseppe; Nascimben, Ennio; Riccioni, Luigi; Turriziani, Ilaria; Volpi, Annalisa; Coniglio, Carlo; Gordini, Giovanni

    2014-01-01

    Background Antibiotic prophylaxis is frequently administered in severe trauma. However, the risk of selecting resistant bacteria, a major issue especially in critical care environments, has not been sufficiently investigated. The aim of the present study was to provide guidelines for antibiotic prophylaxis for four different trauma-related clinical conditions, taking into account the risks of antibiotic-resistant bacteria selection, thus innovating previous guidelines in the field. Methods The MEDLINE database was searched for studies comparing antibiotic prophylaxis to controls (placebo or no antibiotic administration) in four clinical traumatic conditions that were selected on the basis of the traumatic event frequency and/or infection severity. The selected studies focused on the prevention of early ventilator associated pneumonia (VAP) in comatose patients with traumatic brain injury, of meningitis in severe basilar skull fractures, of wound infections in long-bone open fractures. Since no placebo-controlled study was available for deep surgical site-infections prevention in abdominal trauma with enteric contamination, we compared 24-hour and 5-day antibiotic prophylaxis policies. A separate specific research focused on the question of antibiotic-resistant bacteria selection caused by antibiotic prophylaxis, an issue not adequately investigated by the selected studies. Randomised trials, reviews, meta-analyses, observational studies were included. Data extraction was carried out by one author according to a predefined protocol, using an electronic form. The strength of evidence was stratified and recommendations were given according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Results Uncertain evidence deserving further studies was found for two-dose antibiotic prophylaxis for early VAP prevention in comatose patients. In the other cases the risk of resistant-bacteria selection caused by antibiotic administration

  15. Best practices recommendations in the application of immunohistochemistry in testicular tumors: report from the International Society of Urological Pathology consensus conference.

    PubMed

    Ulbright, Thomas M; Tickoo, Satish K; Berney, Daniel M; Srigley, John R

    2014-08-01

    The judicious use of immunostains can be of significant diagnostic assistance in the interpretation of testicular neoplasms when the light microscopic features are ambiguous. A limited differential diagnosis by traditional morphology is required for the effective use of immunohistochemistry (IHC); otherwise, the inevitable occurrence of exceptions to anticipated patterns will lead to "immunoconfusion." The diagnosis of tumors in the germ cell lineage, the great majority of primary tumors of the testis, has been considerably facilitated over the past decade by IHC directed at developmentally important nuclear transcription factors, including OCT4, SALL4, SOX2, and SOX17, that are mostly restricted to certain tumor histotypes. In conjunction with other markers, a specific diagnosis can be achieved in most instances through a panel of 3 or 4 immunostains and often fewer. IHC among tumors in the sex cord-stromal group may produce a significant proportion of false-negative cases until more sensitive and equally specific markers are validated. The negativity of these tumors for the IHC stains used for germ cell tumors is key in the important distinction of neoplasms in these 2 general categories. In this review, the International Society of Urological Pathologists (ISUP) provides diagnostic guidelines in the form of algorithms to assist practicing pathologists confronting a differential diagnostic question concerning a testicular neoplasm. The goal of ISUP is to anticipate commonly encountered differential diagnoses and recommend an efficient and limited pattern of IHC stains to resolve the question.

  16. [Recommendations in neonatal resuscitation].

    PubMed

    2004-01-01

    The recommendations for neonatal resuscitation are not always based on sufficient scientific evidence and thus expert consensus based on current research, knowledge, and experience are useful for formulating practical protocols that are easy to follow. The latest recommendations, in 2000, modified previously published recommendations and are included in the present text.

  17. Geneva rootstocks for weak growing scion cultivars like Honeycrisp

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Duplicate field trials with ‘Honeycrisp’ apple on 22 rootstocks conducted for 9 years at Geneva, NY (in Western NY State) and Peru, NY (in Northern NY State), showed that two dwarf Geneva® stocks (G.41 and G.11) had good tree survival, superior yield performance to M.9, similar fruit size as M.9 and...

  18. Consensus standard requirements and guidance

    SciTech Connect

    Putman, V.L.

    1995-12-01

    This report presents information from the ANS Criticality Alarm System Workshop relating to the consensus standard requirements and guidance. Topics presented include: definition; nomenclature; requirements and recommendations; purpose of criticality alarms; design criteria; signal characteristics; reliability, dependability and durability; tests; and emergency preparedness and planning.

  19. An integrated hospital information system in Geneva.

    PubMed

    Scherrer, J R; Baud, R H; Hochstrasser, D; Ratib, O

    1990-01-01

    Since the initial design phase from 1971 to 1973, the DIOGENE hospital information system at the University Hospital of Geneva has been treated as a whole and has retained its architectural unity, despite the need for modification and extension over the years. In addition to having a centralized patient database with the mechanisms for data protection and recovery of a transaction-oriented system, the DIOGENE system has a centralized pool of operators who provide support and training to the users; a separate network of remote printers that provides a telex service between the hospital buildings, offices, medical departments, and wards; and a three-component structure that avoids barriers between administrative and medical applications. In 1973, after a 2-year design period, the project was approved and funded. The DIOGENE system has led to more efficient sharing of costly resources, more rapid performance of administrative tasks, and more comprehensive collection of information about the institution and its patients.

  20. [Recommendations for the use of faecal microbiota transplantation "stool transplantation": consensus of the Austrian Society of Gastroenterology and Hepatology (ÖGGH) in cooperation with the Austrian Society of Infectious Diseases and Tropical Medicine].

    PubMed

    Kump, P K; Krause, R; Steininger, C; Gröchenig, H P; Moschen, A; Madl, C; Novacek, G; Allerberger, F; Högenauer, C

    2014-12-01

    The intestinal microbiota has a pivotal role in the maintenance of health of the human organism, especially in the defense against pathogenic microorganisms. Alterations in the microbiota, also termed dysbiosis, seem to be involved in the pathogenesis of a variety of intestinal and extraintestinal diseases. Fecal microbiota transplantation (FMT), also known as stool transplantation, is a therapeutic procedure aiming at restoring an altered intestinal microbiota by administration of stool microorganisms from a healthy donor into the intestinal tract of a patient. FMT is most commonly used for recurrent forms of Clostridium difficile infections (CDI). There are currently many cohort studies in a large number of patients and a randomized controlled trial showing a dramatic effect of FMT for this indication. Therefore FMT is recommended by international medical societies for the treatment of recurrent CDI with high scientific evidence. Other potential indications are the treatment of fulminant CDI or the treatment of inflammatory bowel diseases. In the practical utilization of FMT there are currently several open questions regarding the screening of stool donors, the processing of stool and the mode of FMT application. Different modes of FMT application have been described, the application into the colon has to be preferred due to less reported side effects than the application into the upper gastrointestinal tract. So far only very few side effects due to FMT have been reported, nevertheless the use and risks of FMT are currently intensely debated in the medical community. This consensus report of the Austrian society of gastroenterology and hepatology (ÖGGH) in cooperation with the Austrian society of infectious diseases and tropical medicine provides instructions for physicians who want to use FMT which are based on the current medical literature.

  1. The Geneva Faces and Voices (GEFAV) database.

    PubMed

    Ferdenzi, Camille; Delplanque, Sylvain; Mehu-Blantar, Ines; Cabral, Katharin Mylena Da Paz; Felicio, Marisa Domingos; Sander, David

    2015-12-01

    Although many facial and vocal databases are available for research, very few of them have controlled the range of attractiveness of the stimuli that they offer. To fill this gap, we created the GEneva Faces and Voices (GEFAV) database, providing standardized faces (static and dynamic neutral, smiling) and voices (speaking sentences, vowels) of young European adults. A total of 61 women and 50 men 18-35 years old agreed to be part of the GEFAV stimuli, and two rating studies involving 285 participants provided evaluations of the facial and vocal samples. The final set of stimuli was satisfactory in terms of attractiveness range (wide and rather symmetrical distribution over the attractiveness continuum) and the reliability of the ratings (high consistency between the two rating studies, high interrater agreement in the final rating study). Moreover, the database showed an adequate validity, since a series of findings described by earlier research on human attractiveness were confirmed-namely, that facial and vocal attractiveness are predicted by femininity and health in women, and by masculinity, dominance, and trustworthiness in men. In future studies, the GEFAV stimuli may be used intact or transformed, individually or in multimodal combinations, to investigate a wide range of mechanisms, such as the behavioral, neuropsychological, and neurophysiological processes involved in social cognition.

  2. Evaluation of Current Consensus Statement Recommendations for Accelerated Partial Breast Irradiation: A Pooled Analysis of William Beaumont Hospital and American Society of Breast Surgeon MammoSite Registry Trial Data

    SciTech Connect

    Wilkinson, J. Ben; Beitsch, Peter D.; Shah, Chirag; Arthur, Doug; Haffty, Bruce G.; Wazer, David E.; Shaitelman, Simona F.; Lyden, Maureen; Chen, Peter Y.; Vicini, Frank A.

    2013-04-01

    Purpose: To determine whether the American Society for Radiation Oncology (ASTRO) Consensus Statement (CS) recommendations for accelerated partial breast irradiation (APBI) are associated with significantly different outcomes in a pooled analysis from William Beaumont Hospital (WBH) and the American Society of Breast Surgeons (ASBrS) MammoSite® Registry Trial. Methods and Materials: APBI was used to treat 2127 cases of early-stage breast cancer (WBH, n=678; ASBrS, n=1449). Three forms of APBI were used at WBH (interstitial, n=221; balloon-based, n=255; or 3-dimensional conformal radiation therapy, n=206), whereas all Registry Trial patients received balloon-based brachytherapy. Patients were divided according to the ASTRO CS into suitable (n=661, 36.5%), cautionary (n=850, 46.9%), and unsuitable (n=302, 16.7%) categories. Tumor characteristics and clinical outcomes were analyzed according to CS group. Results: The median age was 65 years (range, 32-94 years), and the median tumor size was 10.0 mm (range, 0-45 mm). The median follow-up time was 60.6 months. The WBH cohort had more node-positive disease (6.9% vs 2.6%, P<.01) and cautionary patients (49.5% vs 41.8%, P=.06). The 5-year actuarial ipsilateral breast tumor recurrence (IBTR), regional nodal failure (RNF), and distant metastasis (DM) for the whole cohort were 2.8%, 0.6%, 1.6%. The rate of IBTR was not statistically higher between suitable (2.5%), cautionary (3.3%), or unsuitable (4.6%) patients (P=.20). The nonsignificant increase in IBTR for the cautionary and unsuitable categories was due to increased elsewhere failures and new primaries (P=.04), not tumor bed recurrence (P=.93). Conclusions: Excellent outcomes after breast-conserving surgery and APBI were seen in our pooled analysis. The current ASTRO CS guidelines did not adequately differentiate patients at an increased risk of IBTR or tumor bed failure in this large patient cohort.

  3. Psychological Considerations in the Assessment and Treatment of Pain in Neurorehabilitation and Psychological Factors Predictive of Therapeutic Response: Evidence and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation

    PubMed Central

    Castelnuovo, Gianluca; Giusti, Emanuele M.; Manzoni, Gian Mauro; Saviola, Donatella; Gatti, Arianna; Gabrielli, Samantha; Lacerenza, Marco; Pietrabissa, Giada; Cattivelli, Roberto; Spatola, Chiara A. M.; Corti, Stefania; Novelli, Margherita; Villa, Valentina; Cottini, Andrea; Lai, Carlo; Pagnini, Francesco; Castelli, Lorys; Tavola, Mario; Torta, Riccardo; Arreghini, Marco; Zanini, Loredana; Brunani, Amelia; Capodaglio, Paolo; D'Aniello, Guido E.; Scarpina, Federica; Brioschi, Andrea; Priano, Lorenzo; Mauro, Alessandro; Riva, Giuseppe; Repetto, Claudia; Regalia, Camillo; Molinari, Enrico; Notaro, Paolo; Paolucci, Stefano; Sandrini, Giorgio; Simpson, Susan G.; Wiederhold, Brenda; Tamburin, Stefano

    2016-01-01

    Background: In order to provide effective care to patients suffering from chronic pain secondary to neurological diseases, health professionals must appraise the role of the psychosocial factors in the genesis and maintenance of this condition whilst considering how emotions and cognitions influence the course of treatment. Furthermore, it is important not only to recognize the psychological reactions to pain that are common to the various conditions, but also to evaluate how these syndromes differ with regards to the psychological factors that may be involved. As an extensive evaluation of these factors is still lacking, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) aimed to collate the evidence available across these topics. Objectives: To determine the psychological factors which are associated with or predictive of pain secondary to neurological conditions and to assess the influence of these aspects on the outcome of neurorehabilitation. Methods: Two reviews were performed. In the first, a PUBMED search of the studies assessing the association between psychological factors and pain or the predictive value of these aspects with respect to chronic pain was conducted. The included papers were then rated with regards to their methodological quality and recommendations were made accordingly. In the second study, the same methodology was used to collect the available evidence on the predictive role of psychological factors on the therapeutic response to pain treatments in the setting of neurorehabilitation. Results: The first literature search identified 1170 results and the final database included 189 articles. Factors such as depression, anxiety, pain catastrophizing, coping strategies, and cognitive functions were found to be associated with pain across the various conditions. However, there are differences between chronic musculoskeletal pain, migraine, neuropathy, and conditions associated with complex disability with regards to the

  4. [GEITDAH consensus on attention deficit hyperactivity disorder].

    PubMed

    Montañés-Rada, F; Gastaminza-Pérez, X; Catalá, M A; Ruiz-Sanz, F; Ruiz-Lázaro, P M; Herreros-Rodríguez, O; García-Giral, M; Ortiz-Guerra, J; Alda-Díez, J A; Mojarro-Práxedes, D; Cantó-Díez, T; Mardomingo-Sanz, M J; Sasot-Llevadot, J; Pàmias, M; Rey-Sánchez, F

    2010-11-16

    In this article, the GEITDAH -the Spanish abbreviation of the Special Interest Group on Attention Deficit Hyper-activity Disorder (ADHD)- presents a consensus reached by experts in the management of ADHD from all over Spain. The consensus concerns fundamental aspects that should be the starting point for future local or regional consensus guides. Another aim of this consensus is also to reduce the amount of variability that occurs in the health care offered to patients with ADHD in our country, as well as to act as a stimulus in educational matters. That fact that it is not very long will make it more popular among greater numbers of people and this will allow these goals to be reached more effectively. The conclusions in the consensus guide have been constructed around an introduction dealing with basic aspects and recommendations for diagnosis, treatment (both pharmacological and psychotherapeutic), patient flow and organisational aspects.

  5. Recommendations on pre-hospital & early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine.

    PubMed

    Mebazaa, Alexandre; Yilmaz, M Birhan; Levy, Phillip; Ponikowski, Piotr; Peacock, W Frank; Laribi, Said; Ristic, Arsen D; Lambrinou, Ekaterini; Masip, Josep; Riley, Jillian P; McDonagh, Theresa; Mueller, Christian; deFilippi, Christopher; Harjola, Veli-Pekka; Thiele, Holger; Piepoli, Massimo F; Metra, Marco; Maggioni, Aldo; McMurray, John; Dickstein, Kenneth; Damman, Kevin; Seferovic, Petar M; Ruschitzka, Frank; Leite-Moreira, Adelino F; Bellou, Abdelouahab; Anker, Stefan D; Filippatos, Gerasimos

    2015-06-01

    Acute heart failure is a fatal syndrome. Emergency physicians, cardiologists, intensivists, nurses and other health care providers have to cooperate to provide optimal benefit. However, many treatment decisions are opinion-based and few are evidenced-based. This consensus paper provides guidance to practicing physicians and nurses to manage acute heart failure in the pre-hospital and hospital setting. Criteria of hospitalization and of discharge are described. Gaps in knowledge and perspectives in the management of acute heart failure are also detailed. This consensus paper on acute heart failure might help enable contiguous practice.

  6. Canadian asthma consensus report, 1999

    PubMed Central

    Boulet, L P; Becker, A; Bérubé, D; Beveridge, R; Ernst, P

    1999-01-01

    OBJECTIVES: To provide physicians with current guidelines for the diagnosis and optimal management of asthma in children and adults, including pregnant women and the elderly, in office, emergency department, hospital and clinic settings. OPTIONS: The consensus group considered the roles of education, avoidance of provocative environmental and other factors, diverse pharmacotherapies, delivery devices and emergency and in-hospital management of asthma. OUTCOMES: Provision of the best control of asthma by confirmation of the diagnosis using objective measures, rapid achievement and maintenance of control and regular follow-up. EVIDENCE: The key diagnostic and therapeutic recommendations are based on the 1995 Canadian guidelines and a critical review of the literature by small groups before a full meeting of the consensus group. Recommendations are graded according to 5 levels of evidence. Differences of opinion were resolved by consensus following discussion. VALUES: Respirologists, immunoallergists, pediatricians and emergency and family physicians gave prime consideration to the achievement and maintenance of optimal control of asthma through avoidance of environmental inciters, education of patients and the lowest effective regime of pharmacotherapy to reduce morbidity and mortality. BENEFITS, HARMS AND COSTS: Adherence to the guidelines should be accompanied by significant reduction in patients' symptoms, reduced morbidity and mortality, fewer emergency and hospital admissions, fewer adverse side-effects from medications, better quality of life for patients and reduced costs. RECOMMENDATIONS: Recommendations are included in each section of the report. In summary, after a diagnosis of asthma is made based on clinical evaluation, including demonstration of variable airflow obstruction, and contributing factors are identified, a treatment plan is established to obtain and maintain optimal asthma control. The main components of treatment are patient education

  7. Chemical composition of surficial sediment in Geneva Lake, Wisconsin

    USGS Publications Warehouse

    Elder, John F.; Robertson, Dale M.; Garrison, Paul J.

    2000-01-01

    Intense recreational use of Geneva Lake and extensive residential and other development in its watershed (fig. 1) has created concern over a possible decline in water quality of the lake. Because of this concern, a collaborative effort between the U.S. Geological Survey (USGS), Wiscon- sin Department of Natural Resources (WDNR), and the Geneva Lake Environmental Agency was begun to document the present quality of the water and its sediments, to estimate the amount of nutrients (primarily phosphorus) coming into the lake, and to describe changes that have occurred in the lake over the past 200 years. In this fact sheet, we describe the quality of the surficial sediments of the lake.

  8. The School of Pharmacy Geneva-Lausanne (EPGL) - the first ten years.

    PubMed

    Borchard, Gerrit; Carrupt, Pierre-Alain

    2012-01-01

    With the creation of the School of Pharmacy Geneva-Lausanne (EPGL) in 2003, cantons Geneva and Vaud pooled their resources with the objective of reinforcing the research and teaching in the pharmaceutical sciences. Its core research units cover all aspects of fundamental pharmaceutical research and include collaborative research with the University Hospitals of Geneva and Lausanne.

  9. 45 CFR 506.15 - Geneva Convention of August 12, 1949.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... TITLE I OF THE WAR CLAIMS ACT OF 1948, AS AMENDED ELIGIBILITY REQUIREMENTS FOR COMPENSATION Prisoners of War § 506.15 Geneva Convention of August 12, 1949. The Geneva Convention of August 12, 1949, as identified in section 6(f) of the War Claims Act of 1948, as amended, is the “Geneva Convention Relative...

  10. 45 CFR 506.15 - Geneva Convention of August 12, 1949.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... TITLE I OF THE WAR CLAIMS ACT OF 1948, AS AMENDED ELIGIBILITY REQUIREMENTS FOR COMPENSATION Prisoners of War § 506.15 Geneva Convention of August 12, 1949. The Geneva Convention of August 12, 1949, as identified in section 6(f) of the War Claims Act of 1948, as amended, is the “Geneva Convention Relative...

  11. 45 CFR 506.15 - Geneva Convention of August 12, 1949.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... TITLE I OF THE WAR CLAIMS ACT OF 1948, AS AMENDED ELIGIBILITY REQUIREMENTS FOR COMPENSATION Prisoners of War § 506.15 Geneva Convention of August 12, 1949. The Geneva Convention of August 12, 1949, as identified in section 6(f) of the War Claims Act of 1948, as amended, is the “Geneva Convention Relative...

  12. 45 CFR 506.15 - Geneva Convention of August 12, 1949.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... TITLE I OF THE WAR CLAIMS ACT OF 1948, AS AMENDED ELIGIBILITY REQUIREMENTS FOR COMPENSATION Prisoners of War § 506.15 Geneva Convention of August 12, 1949. The Geneva Convention of August 12, 1949, as identified in section 6(f) of the War Claims Act of 1948, as amended, is the “Geneva Convention Relative...

  13. 45 CFR 506.15 - Geneva Convention of August 12, 1949.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... TITLE I OF THE WAR CLAIMS ACT OF 1948, AS AMENDED ELIGIBILITY REQUIREMENTS FOR COMPENSATION Prisoners of War § 506.15 Geneva Convention of August 12, 1949. The Geneva Convention of August 12, 1949, as identified in section 6(f) of the War Claims Act of 1948, as amended, is the “Geneva Convention Relative...

  14. Brazilian consensus on photoprotection.

    PubMed

    Schalka, Sérgio; Steiner, Denise; Ravelli, Flávia Naranjo; Steiner, Tatiana; Terena, Aripuanã Cobério; Marçon, Carolina Reato; Ayres, Eloisa Leis; Addor, Flávia Alvim Sant'anna; Miot, Helio Amante; Ponzio, Humberto; Duarte, Ida; Neffá, Jane; Cunha, José Antônio Jabur da; Boza, Juliana Catucci; Samorano, Luciana de Paula; Corrêa, Marcelo de Paula; Maia, Marcus; Nasser, Nilton; Leite, Olga Maria Rodrigues Ribeiro; Lopes, Otávio Sergio; Oliveira, Pedro Dantas; Meyer, Renata Leal Bregunci; Cestari, Tânia; Reis, Vitor Manoel Silva dos; Rego, Vitória Regina Pedreira de Almeida

    2014-01-01

    Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection.

  15. Brazilian Consensus on Photoprotection

    PubMed Central

    Schalka, Sérgio; Steiner, Denise; Ravelli, Flávia Naranjo; Steiner, Tatiana; Terena, Aripuanã Cobério; Marçon, Carolina Reato; Ayres, Eloisa Leis; Addor, Flávia Alvim Sant'anna; Miot, Helio Amante; Ponzio, Humberto; Duarte, Ida; Neffá, Jane; da Cunha, José Antônio Jabur; Boza, Juliana Catucci; Samorano, Luciana de Paula; Corrêa, Marcelo de Paula; Maia, Marcus; Nasser, Nilton; Leite, Olga Maria Rodrigues Ribeiro; Lopes, Otávio Sergio; Oliveira, Pedro Dantas; Meyer, Renata Leal Bregunci; Cestari, Tânia; dos Reis, Vitor Manoel Silva; Rego, Vitória Regina Pedreira de Almeida

    2014-01-01

    Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection. PMID:25761256

  16. The Geneva Protocol of 1925: Past and Present.

    ERIC Educational Resources Information Center

    Harbison, John L.

    1982-01-01

    Presents a position paper for use in high school social studies class debates on the Geneva Protocol of 1925. The Protocol was an international agreement to restrict chemical and biological warfare (CBW). The author traces the history of U.S. policies dealing with CBW since 1925. (AM)

  17. Dr. Geneva Gay: Multicultural Education for All Disciplines

    ERIC Educational Resources Information Center

    Atwater, Mary M.

    2010-01-01

    This feature is an interview of Professor Geneva Gay, a leader and expert in multicultural education, especially multicultural curriculum. She graciously consented to a telephone interview, which was recorded. The interview was then transcribed by a professional; this feature is the result of that interview.

  18. [Argentine Consensus of Respiratory Rehabilitation].

    PubMed

    Sívori, Martín; Benzo, Roberto; Rhodius, Edgardo; Jolly, Enrique; Boim, Clarisa; Saadia, Marcela; Conti, Ernesto; Guevara, Ivan; Carles, Daniel; Victorio, Carlos; Santini, Fabian; Ratto, Patricia; Capparelli, Ignacio; Prieto, Ernesto; Azvalinsky, Marcos; Alais, Maria

    2004-01-01

    A group of pulmonologists and physical therapists from the Asociacion Argentina de Medicina Respiratoria revised the scientific literature on Respiratory Rehabilitation (RR) to elaborate evidence-based national recommendations to promote its use. RR is a multidisciplinary program of care for patients with chronic respiratory impairment, individually tailored, designed to optimize physical and social performance and autonomy of patients. It is particularly indicated in patients with Chronic Obstructive Pulmonary Disease (COPD) with exercise intolerance. Inclusion and exclusion criteria, guidelines for initial evaluation and follow up have been defined. The resources needed were defined. It was recommended a hospital ambulatory program with domiciliary complement. A pulmonologist and physical therapist were required for the program as minimum. Aerobic training was recommended for lower limb (LL) (Evidence A) and upper limb (UL) (Evidence B), strength training for LL and UL (Evidence C), as well as respiratory muscles training by resistive inspiratory threshold load (Evidence D) and other physiotherapy techniques were recommended for specific patients. In addition recommendations have been made for educational objectives of the program, nutritional and psychological support. The positive impact of RR on health care was analyzed through the reduction in exacerbation of COPD, length of hospital stay and cost. RR is a key component in the treatment of COPD patients. This evidenced-based consensus statement was prepared to provide recommendations to be implemented nationally.

  19. Multi-Attribute Consensus Building Tool

    ERIC Educational Resources Information Center

    Shyyan, Vitaliy; Christensen, Laurene; Thurlow, Martha; Lazarus, Sheryl

    2013-01-01

    The Multi-Attribute Consensus Building (MACB) method is a quantitative approach for determining a group's opinion about the importance of each item (strategy, decision, recommendation, policy, priority, etc.) on a list (Vanderwood, & Erickson, 1994). This process enables a small or large group of participants to generate and discuss a set…

  20. Pediatric Deceased Donation-A Report of the Transplantation Society Meeting in Geneva.

    PubMed

    Martin, Dominique E; Nakagawa, Thomas A; Siebelink, Marion J; Bramstedt, Katrina A; Brierley, Joe; Dobbels, Fabienne; Rodrigue, James R; Sarwal, Minnie; Shapiro, Ron; Dominguez-Gil, Beatriz; Danovitch, Gabriel; Sweet, Stuart C; Trompeter, Richard S; Moazam, Farhat; Bos, Michael A; Delmonico, Francis L

    2015-07-01

    The Ethics Committee of The Transplantation Society convened a meeting on pediatric deceased donation of organs in Geneva, Switzerland, on March 21 to 22, 2014. Thirty-four participants from Africa, Asia, the Middle East, Oceania, Europe, and North and South America explored the practical and ethical issues pertaining to pediatric deceased donation and developed recommendations for policy and practice. Their expertise was inclusive of pediatric intensive care, internal medicine, and surgery, nursing, ethics, organ donation and procurement, psychology, law, and sociology. The report of the meeting advocates the routine provision of opportunities for deceased donation by pediatric patients and conveys an international call for the development of evidence-based resources needed to inform provision of best practice care in deceased donation for neonates and children.

  1. Evidence-informed recommendations to reduce dissemination bias in clinical research: conclusions from the OPEN (Overcome failure to Publish nEgative fiNdings) project based on an international consensus meeting

    PubMed Central

    Meerpohl, Joerg J; Schell, Lisa K; Bassler, Dirk; Gallus, Silvano; Kleijnen, Jos; Kulig, Michael; La Vecchia, Carlo; Marušić, Ana; Ravaud, Philippe; Reis, Andreas; Schmucker, Christine; Strech, Daniel; Urrútia, Gerard; Antes, Gerd

    2015-01-01

    Background Dissemination bias in clinical research severely impedes informed decision-making not only for healthcare professionals and patients, but also for funders, research ethics committees, regulatory bodies and other stakeholder groups that make health-related decisions. Decisions based on incomplete and biased evidence cannot only harm people, but may also have huge financial implications by wasting resources on ineffective or harmful diagnostic and therapeutic measures, and unnecessary research. Owing to involvement of multiple stakeholders, it remains easy for any single group to assign responsibility for resolving the problem to others. Objective To develop evidence-informed general and targeted recommendations addressing the various stakeholders involved in knowledge generation and dissemination to help overcome the problem of dissemination bias on the basis of previously collated evidence. Methods Based on findings from systematic reviews, document analyses and surveys, we developed general and targeted draft recommendations. During a 2-day workshop in summer 2013, these draft recommendations were discussed with external experts and key stakeholders, and refined following a rigorous and transparent methodological approach. Results Four general, overarching recommendations applicable to all or most stakeholder groups were formulated, addressing (1) awareness raising, (2) implementation of targeted recommendations, (3) trial registration and results posting, and (4) systematic approaches to evidence synthesis. These general recommendations are complemented and specified by 47 targeted recommendations tailored towards funding agencies, pharmaceutical and device companies, research institutions, researchers (systematic reviewers and trialists), research ethics committees, trial registries, journal editors and publishers, regulatory agencies, benefit (health technology) assessment institutions and legislators. Conclusions Despite various recent examples of

  2. Will screening colonoscopy disappear and transform gastroenterology practice? Threats to clinical practice and recommendations to reduce their impact: report of a consensus conference conducted by the AGA Institute Future Trends Committee.

    PubMed

    Regueiro, Carol R

    2006-10-01

    The AGA Institute Future Trends Committee (FTC) developed this report based on a consensus conference it convened on April 1-2, 2006, in Washington, DC. The report was prepared for the FTC by Carol Regueiro, MD, a medical writer under contract to the AGA Institute, and Michael Stolar, PhD, staff liaison to the FTC. It was approved by the FTC on July 12, 2006, and accepted by the AGA Institute Governing Board on July 22, 2006. This report reflects the panel's assessment of information available at the time of the conference. Readers should view this report in the context of data that will continue to accumulate and facts that may change after its creation.

  3. Hydrology and water quality of Geneva Lake, Walworth County, Wisconsin

    USGS Publications Warehouse

    Robertson, Dale M.; Goddard, Gerald L.; Mergener, Elizabeth A.; Rose, William J.; Garrision, Paul J.

    2002-01-01

    Direct measurements and indirect measurements based on sediment-core analyses indicate that the water quality of Geneva Lake has degraded in the last 170 years, the greatest effects resulting from urbanization. Sedimentation rates were highest between 1900 to 1930, and phosphorus concentrations were highest between the 1930s to early 1980s. As a result of the recent reduction in phosphorus loading, in-lake near-surface phosphorus concentrations decreased from 20.25 ?g/L to about 10.15 ?g/L and are similar to those estimated for the lake in the early 1900s. Concentrations of other chemical constituents associated with urban areas, however, have continually increased, especially in Williams Bay and Geneva Bay.

  4. [Consensus on safe infant's furniture: brief version].

    PubMed

    2016-04-01

    Several products that are used for support, transportation or recreation in infants and children can cause non intentional injuries. This consensus tries to provide pediatricians and families with the necessary elements to recognize and choose safe infant's furniture. A group of 24 experts developed a consensus according to Delphi's method, which consists in successiverounds of questions. Recommendations are supported with bibliography. Infant walkers are not recommended, as they are considered useless and dangerous. Guidelines are given to choose appropriate child restraint systems, when and how to use them, and how to install them in a safe way. Injuries and prevention measures related to strollers, high chairs, cribs and bunk beds are described. Risks and the way to avoid them are diagrammed in figures that can be used to transmit recommendations to families.

  5. Consensus protein design

    PubMed Central

    Porebski, Benjamin T.; Buckle, Ashley M.

    2016-01-01

    A popular and successful strategy in semi-rational design of protein stability is the use of evolutionary information encapsulated in homologous protein sequences. Consensus design is based on the hypothesis that at a given position, the respective consensus amino acid contributes more than average to the stability of the protein than non-conserved amino acids. Here, we review the consensus design approach, its theoretical underpinnings, successes, limitations and challenges, as well as providing a detailed guide to its application in protein engineering. PMID:27274091

  6. Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016

    PubMed Central

    Bossé, D.; Ng, T.; Ahmad, C.; Alfakeeh, A.; Alruzug, I.; Biagi, J.; Brierley, J.; Chaudhury, P.; Cleary, S.; Colwell, B.; Cripps, C.; Dawson, L.A.; Dorreen, M.; Ferland, E.; Galiatsatos, P.; Girard, S.; Gray, S.; Halwani, F.; Kopek, N.; Mahmud, A.; Martel, G.; Robillard, L.; Samson, B.; Seal, M.; Siddiqui, J.; Sideris, L.; Snow, S.; Thirwell, M.; Vickers, M.; Goodwin, R.; Goel, R.; Hsu, T.; Tsvetkova, E.; Ward, B.; Asmis, T.

    2016-01-01

    The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016 was held in Montreal, Quebec, 5–7 February. Experts in radiation oncology, medical oncology, surgical oncology, and infectious diseases involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics: ■ Follow-up and survivorship of patients with resected colorectal cancer■ Indications for liver metastasectomy■ Treatment of oligometastases by stereotactic body radiation therapy■ Treatment of borderline resectable and unresectable pancreatic cancer■ Transarterial chemoembolization in hepatocellular carcinoma■ Infectious complications of antineoplastic agents PMID:28050151

  7. Training medical students in human rights: a fifteen-year experience in Geneva

    PubMed Central

    Chastonay, Philippe; Zesiger, Véronique; Ferreira, Jackeline; Mpinga, Emmanuel Kabengele

    2012-01-01

    Background Training health professionals in the field of human rights has long been advocated by the United Nations. Over the past decade some medical schools have introduced health and human rights courses, yet by far not all. This paper describes the objectives and the content of the Health and Human Rights program developed at the Faculty of Medicine, University of Geneva. Methods The health and human rights program was developed through the identification of the course objectives, contents, and educational modalities using consensus techniques, and through a step by step implementation procedure integrating multiple evaluation processes. Results Defined objectives included the familiarization with the concepts, instruments and mechanisms of human rights, the links between health and human rights, and the role of health professionals in promoting human rights. The content ultimately adopted focused on the typology of human rights, their mechanisms of protection, their instruments, as well as social inequalities and vulnerable groups of the population. The implementation proceeded through a step by step approach. Evaluation showed high satisfaction of students, good achievement of learning objectives, and some academic and community impact. Conclusions High interest of students for a human rights course is encouraging. Furthermore, the community projects initiated and implemented by students may contribute to the social responsibility of the academic institution. PMID:26451186

  8. Aljoya Consensus Statement

    EPA Pesticide Factsheets

    A consensus statement of 100 experts meeting at the Aljoya Conference Center in Seattle, Washington in July 2000 for the First International Conference on Trans-Pacific Transport of Atmospheric Contaminants.

  9. Consensus statement on standard of care for congenital muscular dystrophies.

    PubMed

    Wang, Ching H; Bonnemann, Carsten G; Rutkowski, Anne; Sejersen, Thomas; Bellini, Jonathan; Battista, Vanessa; Florence, Julaine M; Schara, Ulrike; Schuler, Pamela M; Wahbi, Karim; Aloysius, Annie; Bash, Robert O; Béroud, Christophe; Bertini, Enrico; Bushby, Kate; Cohn, Ronald D; Connolly, Anne M; Deconinck, Nicolas; Desguerre, Isabelle; Eagle, Michelle; Estournet-Mathiaud, Brigitte; Ferreiro, Ana; Fujak, Albert; Goemans, Nathalie; Iannaccone, Susan T; Jouinot, Patricia; Main, Marion; Melacini, Paola; Mueller-Felber, Wolfgang; Muntoni, Francesco; Nelson, Leslie L; Rahbek, Jes; Quijano-Roy, Susana; Sewry, Caroline; Storhaug, Kari; Simonds, Anita; Tseng, Brian; Vajsar, Jiri; Vianello, Andrea; Zeller, Reinhard

    2010-12-01

    Congenital muscular dystrophies are a group of rare neuromuscular disorders with a wide spectrum of clinical phenotypes. Recent advances in understanding the molecular pathogenesis of congenital muscular dystrophy have enabled better diagnosis. However, medical care for patients with congenital muscular dystrophy remains very diverse. Advances in many areas of medical technology have not been adopted in clinical practice. The International Standard of Care Committee for Congenital Muscular Dystrophy was established to identify current care issues, review literature for evidence-based practice, and achieve consensus on care recommendations in 7 areas: diagnosis, neurology, pulmonology, orthopedics/rehabilitation, gastroenterology/ nutrition/speech/oral care, cardiology, and palliative care. To achieve consensus on the care recommendations, 2 separate online surveys were conducted to poll opinions from experts in the field and from congenital muscular dystrophy families. The final consensus was achieved in a 3-day workshop conducted in Brussels, Belgium, in November 2009. This consensus statement describes the care recommendations from this committee.

  10. Consensus Statement on Standard of Care for Congenital Muscular Dystrophies

    PubMed Central

    Wang, Ching H.; Bonnemann, Carsten G.; Rutkowski, Anne; Sejersen, Thomas; Bellini, Jonathan; Battista, Vanessa; Florence, Julaine M.; Schara, Ulrike; Schuler, Pamela M.; Wahbi, Karim; Aloysius, Annie; Bash, Robert O.; Béroud, Christophe; Bertini, Enrico; Bushby, Kate; Cohn, Ronald D.; Connolly, Anne M.; Deconinck, Nicolas; Desguerre, Isabelle; Eagle, Michelle; Estournet-Mathiaud, Brigitte; Ferreiro, Ana; Fujak, Albert; Goemans, Nathalie; Iannaccone, Susan T.; Jouinot, Patricia; Main, Marion; Melacini, Paola; Mueller-Felber, Wolfgang; Muntoni, Francesco; Nelson, Leslie L.; Rahbek, Jes; Quijano-Roy, Susana; Sewry, Caroline; Storhaug, Kari; Simonds, Anita; Tseng, Brian; Vajsar, Jiri; Vianello, Andrea; Zeller, Reinhard

    2016-01-01

    Congenital muscular dystrophies are a group of rare neuromuscular disorders with a wide spectrum of clinical phenotypes. Recent advances in understanding the molecular pathogenesis of congenital muscular dystrophy have enabled better diagnosis. However, medical care for patients with congenital muscular dystrophy remains very diverse. Advances in many areas of medical technology have not been adopted in clinical practice. The International Standard of Care Committee for Congenital Muscular Dystrophy was established to identify current care issues, review literature for evidence-based practice, and achieve consensus on care recommendations in 7 areas: diagnosis, neurology, pulmonology, orthopedics/rehabilitation, gastroenterology/ nutrition/speech/oral care, cardiology, and palliative care. To achieve consensus on the care recommendations, 2 separate online surveys were conducted to poll opinions from experts in the field and from congenital muscular dystrophy families. The final consensus was achieved in a 3-day workshop conducted in Brussels, Belgium, in November 2009. This consensus statement describes the care recommendations from this committee. PMID:21078917

  11. [SECOT consensus on medial femorotibial osteoarthritis].

    PubMed

    Moreno, A; Silvestre, A; Carpintero, P

    2013-01-01

    A consensus, prepared by SECOT, is presented on the management of medial knee compartment osteoarthritis, in order to establish clinical criteria and recommendations directed at unifying the criteria in its management, dealing with the factors involved in the pathogenesis of medial femorotibial knee osteoarthritis, the usefulness of diagnostic imaging techniques, and the usefulness of arthroscopy. Conservative and surgical treatments are also analysed. The experts consulted showed a consensus (agreed or disagreed) in 65.8% of the items considered, leaving 14items where no consensus was found, which included the aetiopathogenesis of the osteoarthritis, the value of NMR in degenerative disease, the usefulness of COX-2 and the chondroprotective drugs, as well as on the ideal valgus tibial osteotomy technique.

  12. Thailand Consensus on Helicobacter pylori Treatment 2015.

    PubMed

    Mahachai, Varocha; Vilaichone, Ratha-Korn; Pittayanon, Rapat; Rojborwonwitaya, Jarin; Leelakusolvong, Somchai; Kositchaiwat, Chomsri; Mairiang, Pisaln; Praisontarangkul, Ong-Ard; Ovartlarnporn, Buncha; Sottisuporn, Jaksin; Pisespongsa, Pises; Maneerattanaporn, Monthira; Sony, Ravin; Sirinthornpunya, Siam; Chaiyamahapurk, Orawan; Wiwattanachang, Olarn; Sansak, Inchaya; Harnsomboon, Piyathida; Chitapanarux, Taned; Chuenrattanakul, Surapon

    2016-01-01

    Management of Helicobacter pylori infection is an important aspect of many upper gastrointestinal tract diseases, such as chronic gastritis, peptic ulcer disease, gastric cancer and mucosa-associated lymphoid tissue (MALT) lymphoma. The Thailand Consensus on H. pylori treatment 2015 consisted of 22 national experts who took active roles, discussed all important clinical information and investigated clinical aspects in four workshops, focuising on: (1) Diagnosis (2) Treatment (3) Follow-up after eradication and (4) H. pylori infection and special conditions. Experts were invited to participate on the basis of their expertise and contribution to H. pylori works and/or consensus methodology. The results of each workshop were taken to a final consensus vote by all experts. Recommendations were developed from the best evidence and availability to guide clinicians in management of this specific infection associated with variety of clinical outcomes.

  13. Asian Consensus Report on Functional Dyspepsia

    PubMed Central

    Miwa, Hiroto; Ghoshal, Uday C; Gonlachanvit, Sutep; Gwee, Kok-Ann; Ang, Tiing-Leong; Chang, Full-Young; Fock, Kwong Ming; Hongo, Michio; Hou, Xiaohua; Kachintorn, Udom; Ke, Meiyun; Lai, Kwok-Hung; Lee, Kwang Jae; Lu, Ching-Liang; Mahadeva, Sanjiv; Miura, Soichiro; Park, Hyojin; Rhee, Poong-Lyul; Sugano, Kentaro; Vilaichone, Ratha-korn; Wong, Benjamin CY

    2012-01-01

    Background/Aims Environmental factors such as food, lifestyle and prevalence of Helicobacter pylori infection are widely different in Asian countries compared to the West, and physiological functions and genetic factors of Asians may also be different from those of Westerners. Establishing an Asian consensus for functional dyspepsia is crucial in order to attract attention to such data from Asian countries, to articulate the experience and views of Asian experts, and to provide a relevant guide on management of functional dyspepsia for primary care physicians working in Asia. Methods Consensus team members were selected from Asian experts and consensus development was carried out using a modified Delphi method. Consensus teams collected published papers on functional dyspepsia especially from Asia and developed candidate consensus statements based on the generated clinical questions. At the first face-to-face meeting, each statement was reviewed and e-mail voting was done twice. At the second face-to-face meeting, final voting on each statement was done using keypad voting system. A grade of evidence and a strength of recommendation were applied to each statement according to the method of the GRADE Working Group. Results Twenty-nine consensus statements were finalized, including 7 for definition and diagnosis, 5 for epidemiology, 9 for pathophysiology and 8 for management. Algorithms for diagnosis and management of functional dyspepsia were added. Conclusions This consensus developed by Asian experts shows distinctive features of functional dyspepsia in Asia and will provide a guide to the diagnosis and management of functional dyspepsia for Asian primary care physicians. PMID:22523724

  14. 3rd Brazilian Consensus on Helicobacter pylori.

    PubMed

    Coelho, Luiz Gonzaga; Maguinilk, Ismael; Zaterka, Schlioma; Parente, José Miguel; do Carmo Friche Passos, Maria; Moraes-Filho, Joaquim Prado P

    2013-04-01

    Signicant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.

  15. Gunshot deaths in Geneva, Switzerland: 2001 to 2010.

    PubMed

    La Harpe, Romano; Mohamed, Nadja Ben; Burkhardt, Sandra

    2013-09-01

    We have conducted a retrospective study of all gunshot deaths that occurred in Geneva, Switzerland, over a 10-year period (2001-2010). The 133 cases reviewed were classified according to the manner of death, that is, suicide (106 cases), homicide (25 cases), and accident (2 cases). Various data from police authorities and the medicolegal examinations of the bodies were studied, including the age and sex of the victims, location of the event, type of firearm used, concomitant use or nonuse of alcohol and/or other drugs, seasonality, and entry site. These various elements were compared with data found in the literature.

  16. [Tuberculosis screening in school health services in Geneva, Switzerland].

    PubMed

    Meynard, Anne; Pfarrwaller, Eva; Lazarevic, Claire-Anne Wyler

    2016-06-08

    Recent immigrantyouth have multiple health needs that need to be adapted to the context of migration. School health services provide a systematic health check to allyoung immigrants starting school in Geneva, including a tuberculin skin test if coming from a middle or high incidence country. Positive tests are confirmed with Interferon Gamma Release Assay (IGRA) and if indicated, offered treatment of latent tuberculosis even in the absence of clear guidelines. Collective and individual benefits outweigh the difficult logistics: reducing risk of reactivation of latent tuberculosis for populations living in promiscuity, effective collaboration between primary care and school health services to answer the needs of these underserved youth.

  17. Colorectal cancer: consensus for CRC screening, but who addresses the controversies?

    PubMed

    Hoff, Geir

    2014-06-01

    In an update on recommendations for colorectal cancer screening, an Asia–Pacific consensus group has set a good standard for presenting level of agreement to recommendation levels. However, this update also exposes how consensus groups might concentrate on the less controversial issues—leaving the tricky questions in the dark.

  18. [Opioid rotation: from theory to practice. Interdisciplinary recommendations from the Geneva University Hospitals pain network].

    PubMed

    Roulet, L; Luthy, C; Garin, N; Di Pollina de Gold, L; Zoccatelli, D; Escher Imhof, M; Desmeules, J; Piguet, V

    2011-06-29

    Opioids are widely used to treat moderate to severe pain of cancer or non cancer origin. Although opioids provide an adequate analgesia in many patients, their use can be limited by inefficacy and/or intolerable side effects. Opioid rotation is one of the strategies that have been proposed to overcome these therapeutic difficulties. This article revisits the concept of opioid rotation, from pharmacological rational to clinical application.

  19. Concerning Descriptive Standards: A Partnership between Public Archives and Private Collections in Geneva, Switzerland

    ERIC Educational Resources Information Center

    Roth-Lochner, Barbara; Grange, Didier

    2005-01-01

    This paper presents the results of a partnership begun in 2002 in the field of archival description between the Geneva City Archives (AVG) and the Manuscripts Department of the Public and University Library of Geneva (BPU). This cooperation has allowed the creation of two computer applications, which share technical and conceptual foundations.…

  20. Consensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part II: INASL Recommendations for Management of HCV in India

    PubMed Central

    Puri, Pankaj; Anand, Anil C.; Saraswat, Vivek A.; Acharya, Subrat K.; Sarin, Shiv K.; Dhiman, Radha K.; Aggarwal, Rakesh; Singh, Shivaram P.; Amarapurkar, Deepak; Arora, Anil; Chhabra, Mohinish; Chetri, Kamal; Choudhuri, Gourdas; Dixit, Vinod K.; Duseja, Ajay; Jain, Ajay K.; Kapoor, Dharmesh; Kar, Premashis; Koshy, Abraham; Kumar, Ashish; Madan, Kaushal; Misra, Sri P.; Prasad, Mohan V.G.; Nagral, Aabha; Puri, Amarendra S.; Jeyamani, R.; Saigal, Sanjiv; Shah, Samir; Sharma, Praveen K.; Sood, Ajit; Thareja, Sandeep; Wadhawan, Manav

    2014-01-01

    The estimated prevalence of hepatitis C virus (HCV) infection in India is between 0.5 and 1.5% with hotspots showing much higher prevalence in some areas of northeast India, in some tribal populations and in certain parts of Punjab. Genotype 3 is the most prevalent type of infection. Recent years have seen development of a large number of new molecules that are revolutionizing the treatment of hepatitis C. Some of the new directly acting agents (DAAs) like sofosbuvir have been called game-changers because they offer the prospect of interferon-free regimens for the treatment of HCV infection. These new drugs have not yet been approved in India and their cost and availability is uncertain at present. Till these drugs become available at an affordable cost, the treatment that was standard of care for the whole world before these newer drugs were approved should continue to be recommended. For India, cheaper options, which are as effective as the standard-of-care (SOC) in carefully selected patients, are also explored to bring treatment within reach of poorer patients. It may be prudent to withhold treatment at present for selected patients with genotype 1 or 4 infection and low levels of fibrosis (F1 or F2), and for patients who are non-responders to initial therapy, interferon intolerant, those with decompensated liver disease, and patients in special populations such as stable patients after liver and kidney transplantation, HIV co-infected patients and those with cirrhosis of liver. PMID:25755549

  1. Critique, Contextualism and Consensus

    ERIC Educational Resources Information Center

    Green, Jane

    2004-01-01

    In an epistemology of contextualism, how robust does consensus need to be for critique to be practically effective? In 'Relativism and the Critical Potential of Philosophy of Education,' Frieda Heyting proposes a form of contextualism, but her argument raises a number of problems. The kinds of criteria that her version of contextualism will…

  2. 45 CFR 506.16 - Failure to meet the conditions and requirements prescribed under the Geneva Convention of August...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... prescribed under the Geneva Convention of August 12, 1949. 506.16 Section 506.16 Public Welfare Regulations... the conditions and requirements prescribed under the Geneva Convention of August 12, 1949. For the purpose of this part, obligations under the Geneva Convention of August 12, 1949, consist of...

  3. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer

    PubMed Central

    Colombo, Nicoletta; Creutzberg, Carien; Amant, Frederic; Bosse, Tjalling; González-Martín, Antonio; Ledermann, Jonathan; Marth, Christian; Nout, Remi; Querleu, Denis; Mirza, Mansoor Raza; Sessa, Cristiana

    2016-01-01

    Abstract The first joint European Society for Medical Oncology (ESMO), European SocieTy for Radiotherapy & Oncology (ESTRO) and European Society of Gynaecological Oncology (ESGO) consensus conference on endometrial cancer was held on 11–13 December 2014 in Milan, Italy, and comprised a multidisciplinary panel of 40 leading experts in the management of endometrial cancer. Before the conference, the expert panel prepared three clinically-relevant questions about endometrial cancer relating to the following four areas: prevention and screening, surgery, adjuvant treatment and advanced and recurrent disease. All relevant scientific literature, as identified by the experts, was reviewed in advance. During the consensus conference, the panel developed recommendations for each specific question and a consensus was reached. Results of this consensus conference, together with a summary of evidence supporting each recommendation, are detailed in this article. All participants have approved this final article. PMID:26645990

  4. Expert consensus (SBC/SBHCI) on the use of drug-eluting stents: recommendations of the Brazilian society of interventional cardiology/ Brazilian society of cardiology for the Brazilian public single healthcare system.

    PubMed

    Lima, Valter C; Mattos, Luiz Alberto P; Caramori, Paulo R A; Perin, Marco A; Mangione, José A; Machado, Bruno M; Coelho, Wilson M C; Bueno, Ronaldo R L

    2006-10-01

    The authors review percutaneous coronary intervention (PCI) evolution and its growing application in myocardial revascularization for patients with coronary heart disease in Brazil and worldwide. PCI was introduced in 1977 using only the catheter balloon. Limitations of this method (acute occlusion and coronary restenosis) led to the adoption of coronary stents and more recently the advent of drug-eluting stents2, which were developed to drastically reduce restenosis rates. These developments allowed the exponential growth of percutaneous coronary intervention (PCI) procedures in Brazil which have replaced many bypass surgery procedures and have become the gold standard for the majority of symptomatic patients suffering from coronary artery disease. The preference for this procedure gained new dimensions in 2000 when the Brazilian Public Healthcare System (SUS) began reimbursing for stent procedures. This measure exemplified the importance of the Public Healthcare System's participation in incorporating medical advances and offering a high standard of cardiovascular treatment to a large portion of the Brazilian population. It is emphasized that prevention of in-stent restenosis is complex due to its unpredictable and ubiquitous occurrence. Control of this condition improves quality of life and reduces the recurrence of angina pectoris, the need to perform new revascularization procedures and hospital readmissions. The overall success of the drug-eluting stents has proven to be reliable and consistent in overcoming restenosis and has some beneficial impact for all clinical and angiographic conditions. This paper discusses the adoption and criteria for the use of drug-eluting stents in other countries as well as the recommendations established by the Brazilian Society of Interventional Cardiology for their reimbursement by SUS. The incorporation of new healthcare technology involves two distinct stages. During the first stage, the product is registered with the

  5. Consensus Statement Immunonutrition and Exercise.

    PubMed

    Bermon, Stephane; Castell, Lindy M; Calder, Philip C; Bishop, Nicolette C; Blomstrand, Eva; Mooren, Frank C; Krüger, Karsten; Kavazis, Andreas N; Quindry, John C; Senchina, David S; Nieman, David C; Gleeson, Michael; Pyne, David B; Kitic, Cecilia M; Close, Graeme L; Larson-Meyer, D Enette; Marcos, Ascension; Meydani, Simin N; Walsh, Neil P; Nagatomi, Ryochi

    2017-01-01

    In this consensus statement on immunonutrition and exercise, a panel of knowledgeable contributors from across the globe provides a consensus of updated science, including the background, the aspects for which a consensus actually exists, the controversies and, when possible, suggested directions for future research.

  6. Clinical Data Models at University Hospitals of Geneva.

    PubMed

    Vishnyakova, Dina; Gaudet-Blavignac, Christophe; Baumann, Philippe; Lovis, Christian

    2016-01-01

    In order to reuse data for clinical research it is then necessary to overcome two main challenges - to formalize data sources and to increase the portability. Once the challenge is resolved, it then will allow research applications to reuse clinical data. In this paper, three data models such as entity-attribute-value, ontological and data-driven are described. Their further implementation at University Hospitals of Geneva (HUG) in the data integration methodologies for operational healthcare data sources of the European projects such as DebugIT and EHR4CR and national project the Swiss Transplant Cohort Study are explained. In these methodologies the clinical data are either aligned according to standardised terminologies using different processing techniques or transformed and loaded directly to data models. Then these models are compared and discussed based on the quality criteria. The comparison shows that the described data models are strongly dependent on the objectives of the projects.

  7. Towards Consensus Gene Ages

    PubMed Central

    Liebeskind, Benjamin J.; McWhite, Claire D.; Marcotte, Edward M.

    2016-01-01

    Correctly estimating the age of a gene or gene family is important for a variety of fields, including molecular evolution, comparative genomics, and phylogenetics, and increasingly for systems biology and disease genetics. However, most studies use only a point estimate of a gene’s age, neglecting the substantial uncertainty involved in this estimation. Here, we characterize this uncertainty by investigating the effect of algorithm choice on gene-age inference and calculate consensus gene ages with attendant error distributions for a variety of model eukaryotes. We use 13 orthology inference algorithms to create gene-age datasets and then characterize the error around each age-call on a per-gene and per-algorithm basis. Systematic error was found to be a large factor in estimating gene age, suggesting that simple consensus algorithms are not enough to give a reliable point estimate. We also found that different sources of error can affect downstream analyses, such as gene ontology enrichment. Our consensus gene-age datasets, with associated error terms, are made fully available at so that researchers can propagate this uncertainty through their analyses (geneages.org). PMID:27259914

  8. Spanish Consensus Statement

    PubMed Central

    Rey, Guillermo Álvarez; Cuesta, Jordi Ardevol; Loureda, Rafael Arriaza; España, Fernando Ávila; Matas, Ramón Balius; Pazos, Fernando Baró; de Dios Beas Jiménez, Juan; Rosell, Jorge Candel; Fernandez, César Cobián; Ros, Francisco Esparza; Colmenero, Josefina Espejo; de Prado, Jorge Fernández; Cota, Juan José García; González, Jose Ignacio Garrido; Santander, Manuela González; Munilla, Miguel Ángel Herrador; Ruiz, Francisco Ivorra; Díaz, Fernando Jiménez; Marqueta, Pedro Manonelles; Fernandez, Antonio Maestro; Benito, Juan José Muñoz; Vilás, Ramón Olivé; Teres, Xavier Peirau; Amaro, José Peña; Roque, Juan Pérez San; Parenteu, Christophe Ramírez; Serna, Juan Ribas; Álvarez, Mikel Sánchez; Marchori, Carlos Sanchez; Soto, Miguel del Valle; Alonso, José María Villalón; García, Pedro Guillen; de la Iglesia, Nicolas Hugo; Alcorocho, Juan Manuel Lopez

    2015-01-01

    On the 21st of March, 2015, experts met at Clínica CEMTRO in Madrid, Spain, under the patronage of The Spanish Society for Sports Traumatology (SETRADE), The Spanish Federation of Sports Medicine (FEMEDE), The Spanish Association of Medical Services for Football Clubs (AEMEF), and The Spanish Association of Medical Services for Basketball Clubs (AEMB) with the aim of establishing a round table that would allow specialists to consider the most appropriate current general actions to be taken when treating muscle tears in sport, based on proven scientific data described in the medical literature. Each expert received a questionnaire prior to the aforementioned meeting comprising a set of questions concerning therapeutic indications generally applied in the different stages present during muscle repair. The present Consensus Document is the result of the answers to the questionnaire and resulting discussion and consensus over which are the best current indications in the treatment of muscle tears in sport. Avoiding immobilization, not taking nonsteroidal anti-inflammatory drugs (NSAIDs) randomly, fostering early mobilization, increasing vascularization of injured, site and regulating inflammatory mechanisms—without inhibiting these from the early stages of the recovery period—all stood out as main points of the Consensus Document. Additionally, there is controversy concerning cell stimulation techniques and the use of growth factors or cell inhibitors. The decision concerning discharge was unanimous, as was the criteria considered when it came to performing sport techniques without pain. PMID:27213161

  9. IV Spanish Consensus Conference on Helicobacter pylori infection treatment.

    PubMed

    Gisbert, Javier P; Molina-Infante, Javier; Amador, Javier; Bermejo, Fernando; Bujanda, Luis; Calvet, Xavier; Castro-Fernández, Manuel; Cuadrado-Lavín, Antonio; Elizalde, J Ignasi; Gene, Emili; Gomollón, Fernando; Lanas, Ángel; Martín de Argila, Carlos; Mearin, Fermín; Montoro, Miguel; Pérez-Aisa, Ángeles; Pérez-Trallero, Emilio; McNicholl, Adrián G

    2016-12-01

    Helicobacter pylori approximately infect 50% of Spanish population and causes chronic gastritis, peptic ulcer and gastric cancer. Until now, three consensus meetings on H.pylori infection had been performed in Spain (the last in 2012). The changes in the treatment schemes, and the increasing available evidence, have justified organizing the IVSpanish Consensus Conference (March 2016), focused on the treatment of this infection. Nineteen experts participated, who performed a systematic review of the scientific evidence and developed a series of recommendation that were subjected to an anonymous Delphi process of iterative voting. Scientific evidence and the strength of the recommendation were classified using GRADE guidelines. As starting point, this consensus increased the minimum acceptable efficacy of recommended treatments that should reach, or preferably surpass, the 90% cure rate when prescribed empirically. Therefore, only quadruple therapies (with or without bismuth), and generally lasting 14 days, are recommended both for first and second line treatments. Non-bismuth quadruple concomitant regimen, including a proton pump inhibitor, clarithromycin, amoxicillin and metronidazole, is recommended as first line. In the present consensus, other first line alternatives and rescue treatments are also reviewed and recommended.

  10. Achieving consensus in environmental programs

    SciTech Connect

    Kurstedt, Jr., H. A.; Jones, R. M.; Walker, J. A.; Middleman, L. I.

    1989-01-01

    In this paper, we describe a new research effort on consensus tied to the Environmental Restoration Program (ERP) within the US Department of Energy's Office of Defense Waste and Transportation Management (DWTM). We define consensus and explain why consensus decisions are not merely desirable but necessary in furthering ERP activities. As examples of our planned applied research, we first discuss Nominal Group Technique as a representative consensus-generating tool, and we conclude by describing the consensus-related mission of the Waste Management Review Group, established at Virginia Tech to conduct independent, third-party review of DWTM/ERP plans and activities. 10 refs.

  11. Microscopic enteritis: Bucharest consensus.

    PubMed

    Rostami, Kamran; Aldulaimi, David; Holmes, Geoffrey; Johnson, Matt W; Robert, Marie; Srivastava, Amitabh; Fléjou, Jean-François; Sanders, David S; Volta, Umberto; Derakhshan, Mohammad H; Going, James J; Becheanu, Gabriel; Catassi, Carlo; Danciu, Mihai; Materacki, Luke; Ghafarzadegan, Kamran; Ishaq, Sauid; Rostami-Nejad, Mohammad; Peña, A Salvador; Bassotti, Gabrio; Marsh, Michael N; Villanacci, Vincenzo

    2015-03-07

    Microscopic enteritis (ME) is an inflammatory condition of the small bowel that leads to gastrointestinal symptoms, nutrient and micronutrient deficiency. It is characterised by microscopic or sub-microscopic abnormalities such as microvillus changes and enterocytic alterations in the absence of definite macroscopic changes using standard modern endoscopy. This work recognises a need to characterize disorders with microscopic and submicroscopic features, currently regarded as functional or non-specific entities, to obtain further understanding of their clinical relevance. The consensus working party reviewed statements about the aetiology, diagnosis and symptoms associated with ME and proposes an algorithm for its investigation and treatment. Following the 5(th) International Course in Digestive Pathology in Bucharest in November 2012, an international group of 21 interested pathologists and gastroenterologists formed a working party with a view to formulating a consensus statement on ME. A five-step agreement scale (from strong agreement to strong disagreement) was used to score 21 statements, independently. There was strong agreement on all statements about ME histology (95%-100%). Statements concerning diagnosis achieved 85% to 100% agreement. A statement on the management of ME elicited agreement from the lowest rate (60%) up to 100%. The remaining two categories showed general agreement between experts on clinical presentation (75%-95%) and pathogenesis (80%-90%) of ME. There was strong agreement on the histological definition of ME. Weaker agreement on management indicates a need for further investigations, better definitions and clinical trials to produce quality guidelines for management. This ME consensus is a step toward greater recognition of a significant entity affecting symptomatic patients previously labelled as non-specific or functional enteropathy.

  12. WHO Working Group on Technical Specifications for Manufacture and Evaluation of Yellow Fever Vaccines, Geneva, Switzerland, 13-14 May 2009.

    PubMed

    Ferguson, Morag; Shin, Jinho; Knezevic, Ivana; Minor, Philip; Barrett, Alan

    2010-12-06

    In May 2009, WHO convened a meeting of Working Group on Technical Specifications for Manufacturing and Evaluating Yellow Fever (YF) Vaccines, Geneva, Switzerland to initiate revision of the WHO Recommendations (formerly, Requirements) for YF vaccine published in WHO Technical Report Series number 872 (1998). The Working Group, consisting of experts from academia, industry, national regulatory authorities and national control laboratories, reviewed the latest issues of safety, efficacy and quality of YF vaccines and agreed that (i) the revision should focus on live attenuated YF vaccine virus 17D lineage; and that (ii) nonclinical and clinical guidelines for new vaccines prepared from 17D lineage be developed.

  13. [Mexican consensus on portal hypertension].

    PubMed

    Narváez-Rivera, R M; Cortez-Hernández, C A; González-González, J A; Tamayo-de la Cuesta, J L; Zamarripa-Dorsey, F; Torre-Delgadillo, A; Rivera-Ramos, J F J; Vinageras-Barroso, J I; Muneta-Kishigami, J E; Blancas-Valencia, J M; Antonio-Manrique, M; Valdovinos-Andraca, F; Brito-Lugo, P; Hernández-Guerrero, A; Bernal-Reyes, R; Sobrino-Cossío, S; Aceves-Tavares, G R; Huerta-Guerrero, H M; Moreno-Gómez, N; Bosques-Padilla, F J

    2013-01-01

    The aim of the Mexican Consensus on Portal Hypertension was to develop documented guidelines to facilitate clinical practice when dealing with key events of the patient presenting with portal hypertension and variceal bleeding. The panel of experts was made up of Mexican gastroenterologists, hepatologists, and endoscopists, all distinguished professionals. The document analyzes themes of interest in the following modules: preprimary and primary prophylaxis, acute variceal hemorrhage, and secondary prophylaxis. The management of variceal bleeding has improved considerably in recent years. Current information indicates that the general management of the cirrhotic patient presenting with variceal bleeding should be carried out by a multidisciplinary team, with such an approach playing a major role in the final outcome. The combination of drug and endoscopic therapies is recommended for initial management; vasoactive drugs should be started as soon as variceal bleeding is suspected and maintained for 5 days. After the patient is stabilized, urgent diagnostic endoscopy should be carried out by a qualified endoscopist, who then performs the corresponding endoscopic variceal treatment. Antibiotic prophylaxis should be regarded as an integral part of treatment, started upon hospital admittance and continued for 5 days. If there is treatment failure, rescue therapies should be carried out immediately, taking into account that interventional radiology therapies are very effective in controlling refractory variceal bleeding. These guidelines have been developed for the purpose of achieving greater clinical efficacy and are based on the best evidence of portal hypertension that is presently available.

  14. 3D mapping and simulation of Geneva Lake environmental data

    NASA Astrophysics Data System (ADS)

    Villard, Roch; Maignan, Michel; Kanevski, Mikhail; Rapin, Francois; Klein, Audrey

    2010-05-01

    The Geneva Lake is the biggest alpine and subalpine lake in central Europe. The depth of this lake is 309 meters and its total volume of water is 89 billions m3. It takes, on average, around twelve years so that waters of the lake are completely brewed. Furthermore the Geneva lake waters are rich in dissolved substances as carbonate, sulfate. The quantity of particles in suspension in the lake, which mainly arrived from the Rhône, is nowadays around height million of tones. The International Commission for the Leman Lake (CIPEL) works about the improvement of the quality of this lake since 1962. In the present study three dimensional environmental data (temperature, oxygen and nitrate) which cover the period from 1954 to 2008, for a total of 27'500 cases are investigated. We are interested to study the evolution of the temperature of the lake because there is an impact on the reproduction of fishes and also because the winter brewing of the water makes the re-oxygenation of deep-water. In order that biological balance is maintained in a lake, there must be enough oxygen in the water. Moreover, we work on nitrate distribution and evolution because contributions in fertilizers cause eutrophication of lake. The data are very numerous when we consider the time series, some of them with more than 300 occurrences, but there are between 2 and 15 data available for spatial cartography. The basic methodology used for the analysis, mapping and simulations of 3D patterns of environmental data is based on geostatistical predictions (family of kriging models) and conditional stochastic simulations. Spatial and temporal variability, 3D monitoring networks changing over time, make this study challenging. An important problem is also to make interpolation/simulations over a long period of time, like ten years. One way used to overcome this problem, consists in using a weighted average of ten variograms during this period. 3D mapping was carried out using environment data for

  15. Environmental Sensing of Aquatic Systems at the University of Geneva.

    PubMed

    Bakker, Eric; Tercier-Waeber, Mary-Lou; Cherubini, Thomas; Crespi, Miquel Coll; Crespo, Gastón A; Cuartero, Maria; Afshar, Majid Ghahraman; Jarolimova, Zdenka; Jeanneret, Stéphane; Mongin, Sandrine; Néel, Bastien; Pankratova, Nadezda; Touilloux, Romain; Xie, Xiaojiang; Zhai, Jingying

    2014-11-01

    Aquatic environments are complex living systems where biological and chemical constituents change rapidly with time and space and may exhibit synergistic interactions. To understand these processes, the traditional approach based on a typically monthly collection of samples followed by laboratory analysis is not adequate. It must be replaced by high-resolution autonomous in situ detection approaches. In our group at the University of Geneva, we aim to develop and deploy chemical sensor probes to understand complex aquatic systems. Most research centers around electrochemical sensing approaches, which involves: stripping voltammetry at gel-coated microelectrode arrays for direct measurements of bioavailable essential or toxic trace metals; direct potentiometry for the measurement of nutrients and other species involved in the nitrogen and carbon cycles; online desalination for oceanic measurements; the development of robust measurement principles such as thin layer coulometry, and speciation analysis by tandem electrochemical detection with potentiometry and dynamic electrochemistry. These fundamental developments are combined with instrument design, both in-house and with external partners, and result in field deployments in partnership with environmental researchers in Switzerland and the European Union.

  16. [Sexual assaults in Geneva between 2006 and 2010].

    PubMed

    La Harpe, Romano; Vlastos, Anne-Thérèse

    2012-01-01

    In Geneva, all sexual assault victims are examined both by a gynaecologist and a forensic pathologist with special training in clinical forensic medicine. Between 2006 and 2010, 473 victims were examined following such an assault. Over the years, the number of sexual assaults rose steadily. Most victims were aged between 15 and 30 years. The majority of the assaults occurred at night and on the weekend and often happened at the place where the perpetrator or the victim lived. Usually, the offender acted alone and was known to the victim. Many victims hesitate to present for an examination, which makes it difficult to collect evidence. Penetration was usually vaginal and without the use of a condom. Injuries on the body or genitals were seen in only half of the cases for the first ones and in less than one third for the second ones. Quite often (at least in 42 % of the cases), the victim consumed alcohol before the assault and the use of drugs--especially cannabis--was not uncommon either.

  17. [Preliminary evaluation of Chile's First Citizen Consensus Conference].

    PubMed

    Pellegrini Filho, Alberto; Zurita, Laura

    2004-05-01

    This piece provides an initial assessment of the First Citizen Consensus Conference, an event held in the city of Santiago, Chile, from 22-24 November 2003, on the subject of "The Management of My Medical Record." This conference was the first citizen consensus conference that has been held in Chile as well as the first such conference in Latin America. Consensus conferences were devised by the Danish Board of Technology in 1987 as a way to assess science and technology issues through discussions between experts and a panel of lay persons. At the end of a consensus conference, the lay persons express their opinions and recommendations in a consensus report that is directed at policymakers, decision-makers, and the public in general. The objective of a consensus conference is to bridge the gaps that routinely exist among the general public, experts, and elected officials. So far, the Danish Board of Technology has organized more than 20 of these conferences, using a methodology that has become established as a model. Taking into account the changes that have occurred in the relationship between science and society at large, the Pan American Health Organization has decided to support the holding of consensus conferences in Latin America and the Caribbean. The First Citizen Consensus Conference adapted the Danish methodology to conditions in Chile, and this piece assesses the modifications that were made. In addition, some 6 to 12 months after the conference, there will be an external evaluation of the outcomes and impact of the conference, especially in the communications media, public debate, decision-making, and perceptions of the persons who were involved. Despite the criticisms made in this piece and some shortcomings that are pointed out, the First Citizen Consensus Conference achieved all of its objectives and will serve as an excellent model for similar conferences in other countries of the Americas.

  18. Population conference: consensus and conflict.

    PubMed

    Willson, P D

    1984-01-01

    The United Nations-sponsored International Conference on Population held in Mexico City was both a rejection and an affirmation of a new policy of the Reagan administration. The policy denies international family planning funds to nongovernmental organizations that perform or actively promote abortion as a family planning method in other nations. A compromise statement was accepted urging governments to take appropriate measures to discourage abortion as a family planning method and when possible to provide for the humane treatment and counseling of women ho resorted to abortion. The statement on abortion was 1 of 88 reccomendations approved by the conference. The commitment expressed in the 10-year-old World Population Plan of Action to the rights and responsiblity to all people as reaffirmed. The conference also endorsed family life education and sex education as well as suitable family planning, information and services for adolescents, with due consideration given to the role, rights and obligations of parents. Increased support for international population and family planning programs was urged and World Bank President, Clausen, urged a 4-fold increase in international funding by the year 2000. Most of the conference's recommendations re devoted to the broad range of population policy issues, including morbidity and mortality, international and internal migration, the relationship between population and economic development and the status of women. The purpose of the recommendations is to increase the momentum of international support. The Mexico City conference was characterized by a remarkable degree of consensus about population policies with respect to integration with economic development, the need to respect individual rights and the recognition that all nations have sovereign rights to develop and implement their own population policies. Conflict and controversy arose in the areas of the arms race and the Middle East. The US position on abortion funding

  19. Consensus on consensus: a synthesis of consensus estimates on human-caused global warming

    NASA Astrophysics Data System (ADS)

    Cook, John; Oreskes, Naomi; Doran, Peter T.; Anderegg, William R. L.; Verheggen, Bart; Maibach, Ed W.; Carlton, J. Stuart; Lewandowsky, Stephan; Skuce, Andrew G.; Green, Sarah A.; Nuccitelli, Dana; Jacobs, Peter; Richardson, Mark; Winkler, Bärbel; Painting, Rob; Rice, Ken

    2016-04-01

    The consensus that humans are causing recent global warming is shared by 90%-100% of publishing climate scientists according to six independent studies by co-authors of this paper. Those results are consistent with the 97% consensus reported by Cook et al (Environ. Res. Lett. 8 024024) based on 11 944 abstracts of research papers, of which 4014 took a position on the cause of recent global warming. A survey of authors of those papers (N = 2412 papers) also supported a 97% consensus. Tol (2016 Environ. Res. Lett. 11 048001) comes to a different conclusion using results from surveys of non-experts such as economic geologists and a self-selected group of those who reject the consensus. We demonstrate that this outcome is not unexpected because the level of consensus correlates with expertise in climate science. At one point, Tol also reduces the apparent consensus by assuming that abstracts that do not explicitly state the cause of global warming (‘no position’) represent non-endorsement, an approach that if applied elsewhere would reject consensus on well-established theories such as plate tectonics. We examine the available studies and conclude that the finding of 97% consensus in published climate research is robust and consistent with other surveys of climate scientists and peer-reviewed studies.

  20. Between consensus and contestation.

    PubMed

    Weale, Albert

    2016-08-15

    Purpose - Noting that discussions of public participation and priority setting typically presuppose certain political theories of democracy, the purpose of this paper is to discuss two theories: the consensual and the agonistic. The distinction is illuminating when considering the difference between institutionalized public participation and contestatory participation. Design/methodology/approach - The approach is a theoretical reconstruction of two ways of thinking about public participation in relation to priority setting in health care, drawing on the work of Habermas, a deliberative theorist, and Mouffe, a theorist of agonism. Findings - The different theoretical approaches can be associated with different ways of understanding priority setting. In particular, agonistic democratic theory would understand priority setting as system of inclusions and exclusions rather than the determination of a consensus of social values, which is the typical deliberative way of thinking about the issues. Originality/value - The paper shows the value of drawing out explicitly the tacit assumptions of practices of political participation in order to reveal their scope and limitations. It suggests that making such theoretical presuppositions explicit has value for health services management in recognizing these implicit choices.

  1. [International Society of Urological Pathology (ISUP) Consensus Conference on handling and staging of radical prostatectomy specimens].

    PubMed

    Compérat, Eva; Camparo, Philippe; Srigley, John; Delahunt, Brett; Egevad, Lars

    2013-06-01

    The 2009 International Society of Urological Pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens issued recommendations for standardization of pathology reporting of radical prostatectomy specimens. The conference addressed specimen handling, T2 substaging, prostate cancer volume, extraprostatic extension, lymphovascular invasion, seminal vesicle invasion, lymph node metastases and surgical margins. This review summarizes the conclusions and recommendations resulting from the consensus process.

  2. A consensus approach to wound care in epidermolysis bullosa

    PubMed Central

    Pope, Elena; Lara-Corrales, Irene; Mellerio, Jemima; Martinez, Anna; Schultz, Gregory; Burrell, Robert; Goodman, Laurie; Coutts, Patricia; Wagner, John; Allen, Upton; Sibbald, Gary

    2013-01-01

    Background Wound care is the cornerstone of treatment for patients with epidermolysis bullosa (EB); however, there are currently no guidelines to help practitioners care for these patients. Objectives The objective of this study was to generate a list of recommendations that will enable practitioners to better care for patients with EB. Methods An expert panel generated a list of recommendations based on the best evidence available. The recommendations were translated into a survey, and sent to other EB experts to generate consensus using an online-based modified Delphi method. The list was refined and grouped into themes and specific recommendations. Results There were15 respondents (45% response rate), with significant experience in the EB field (>10 years [67%]). Respondents included physicians (67%), nurses (17%), and allied health professionals (7%). There was more than 85% agreement for all the proposed items. These were further refined and grouped into 5 main themes (assessment and management of factors that impair healing, patient-centered concerns, local wound care, development of an individualized care plan, and organizational support) and 17 specific recommendations. Limitations There is a paucity of scientific evidence with most recommendations based on expert opinion. Conclusions These recommendations will provide practitioners with a framework for caring for these patients. Additional scientific research including effectiveness studies for everyday practice and expert consensus, may further refine these recommendations. PMID:22387035

  3. Kyoto global consensus report on Helicobacter pylori gastritis

    PubMed Central

    Sugano, Kentaro; Tack, Jan; Kuipers, Ernst J; Graham, David Y; El-Omar, Emad M; Miura, Soichiro; Haruma, Ken; Asaka, Masahiro; Uemura, Naomi; Malfertheiner, Peter

    2015-01-01

    Objective To present results of the Kyoto Global Consensus Meeting, which was convened to develop global consensus on (1) classification of chronic gastritis and duodenitis, (2) clinical distinction of dyspepsia caused by Helicobacter pylori from functional dyspepsia, (3) appropriate diagnostic assessment of gastritis and (4) when, whom and how to treat H. pylori gastritis. Design Twenty-three clinical questions addressing the above-mentioned four domains were drafted for which expert panels were asked to formulate relevant statements. A Delphi method using an anonymous electronic system was adopted to develop the consensus, the level of which was predefined as ≥80%. Final modifications of clinical questions and consensus were achieved at the face-to-face meeting in Kyoto. Results All 24 statements for 22 clinical questions after extensive modifications and omission of one clinical question were achieved with a consensus level of >80%. To better organise classification of gastritis and duodenitis based on aetiology, a new classification of gastritis and duodenitis is recommended for the 11th international classification. A new category of H. pylori-associated dyspepsia together with a diagnostic algorithm was proposed. The adoption of grading systems for gastric cancer risk stratification, and modern image-enhancing endoscopy for the diagnosis of gastritis, were recommended. Treatment to eradicate H. pylori infection before preneoplastic changes develop, if feasible, was recommended to minimise the risk of more serious complications of the infection. Conclusions A global consensus for gastritis was developed for the first time, which will be the basis for an international classification system and for further research on the subject. PMID:26187502

  4. Consensus guidelines for the use of ultrasound for diving research.

    PubMed

    Møllerløkken, Andreas; Blogg, S Lesley; Doolette, David J; Nishi, Ronald Y; Pollock, Neal W

    2016-03-01

    The International Meeting on Ultrasound for Diving Research produced expert consensus recommendations for ultrasound detection of vascular gas bubbles and the analysis, interpretation and reporting of such data. Recommendations for standardization of techniques to allow comparison between studies included bubble monitoring site selection, frequency and duration of monitoring, and use of the Spencer, Kisman-Masurel or Eftedal-Brubakk scales. Recommendations for reporting of results included description of subject posture and provocation manoeuvres during monitoring, reporting of untransformed data and the appropriate use of statistics. These guidelines are available from www.dhmjournal.com.

  5. Standardised neonatal parenteral nutrition formulations - an Australasian group consensus 2012.

    PubMed

    Bolisetty, Srinivas; Osborn, David; Sinn, John; Lui, Kei

    2014-02-18

    Standardised parenteral nutrition formulations are routinely used in the neonatal intensive care units in Australia and New Zealand. In 2010, a multidisciplinary group was formed to achieve a consensus on the formulations acceptable to majority of the neonatal intensive care units. Literature review was undertaken for each nutrient and recommendations were developed in a series of meetings held between November 2010 and April 2011. Three standard and 2 optional amino acid/dextrose formulations and one lipid emulsion were agreed by majority participants in the consensus. This has a potential to standardise neonatal parenteral nutrition guidelines, reduce costs and prescription errors.

  6. The Geneva Conferences and the emergence of the International Network for Person-centered Medicine.

    PubMed

    Mezzich, Juan E

    2011-04-01

    The yearly Geneva Conferences on Person-centered Medicine started in May 2008 as a collaborative effort of global medical and health organizations and committed clinicians and scholars to place the whole person at the centre of medicine and health care. They were informed by the traditions of great ancient civilizations and recent developments in clinical care and public health. The process of the Geneva Conferences led to the development of the International Network for Person-centered Medicine as a non-for-profit institution aimed at organizing future editions of the Geneva Conference and building person-centred medicine as a paradigmatic repriorizing of the medical and health fields in collaboration inter alia with the World Medical Association, the World Health Organization and the World Organization of Family Doctors.

  7. Consensus development for healthcare professionals.

    PubMed

    Kea, Bory; Sun, Benjamin Chih-An

    2015-04-01

    Consensus development sprang from a desire to synthesize clinician and expert opinions on clinical practice and research agendas in the 1950s. And since the American Institute of Medicine formally defined "guidelines" in 1990, there has been a proliferation of clinical practice guidelines (CPG) both formally and informally. This modern decision-making tool used by both physicians and patients, requires extensive planning to overcome the challenges of consensus development while reaping its rewards. Consensus allows for a group approach of multiple experts sharing ideas to form consensus on topics ranging from appropriateness of procedures to research agenda development. Disagreements can shed light on areas of controversy and launch further discussions. It has five main components: three inputs (defining the task, participant identification and recruitment, and information synthesis), the approach (consensus development by explicit or implicit means), and the output (dissemination of results). Each aspect requires extensive planning a priori as they influence the entire process, from how information will be interpreted, the interaction of participants, the resulting judgment, to whether there will be uptake of results. Implicit approaches utilize qualitative methods and/or a simple voting structure of majority wins, and are used in informal consensus development methods and consensus development conferences. Explicit approaches aggregate results or judgments using explicit rules set a priori with definitions of "agreement" or consensus. Because the implicit process can be more opaque, unforeseen challenges can emerge such as the undue influence of a minority. And yet, the logistics of explicit approaches may be more time consuming and not appropriate when speed is a priority. In determining which method to use, it is important to understand the pros and cons of different approaches and how it will affect the overall input, approach, and outcome.

  8. Consensus Algorithms Over Fading Channels

    DTIC Science & Technology

    2010-10-01

    studying the effect of fading and collisions on the performance of wireless consensus gossiping and in comparing its cost (measured in terms of number of...not assumed to be symmetric under A2. III. RELATED WORK There has been a resurgence of interest in characterizing consen- sus and gossip algorithms...tree, and then distribute the consensus value, with a finite number of exchanges. The price paid is clearly that of finding the appropriate routing

  9. Consensus development for healthcare professionals

    PubMed Central

    Kea, Bory; Sun, Benjamin C.

    2015-01-01

    Consensus development sprang from a desire to synthesize clinician and expert opinions on clinical practice and research agendas in the 1950s. And since the American Institute of Medicine formally defined “guidelines” in 1990, there has been a proliferation of clinical practice guidelines (CPG) both formally and informally. This modern decision making tool used by both physicians and patients, requires extensive planning to meet the challenges of consensus development while reaping its rewards. Consensus allows for a group approach with multiple experts sharing ideas to form consensus on topics ranging from appropriateness of procedures to research agenda development. Disagreements can shed light on areas of controversy and launch further discussions. It has five main components: three inputs (defining the task, participant identification and recruitment, and information synthesis), the approach (consensus development by explicit or implicit means), and the output (dissemination of results). Each aspect requires extensive planning a priori as they influence the entire process, from how information will be interpreted, the interaction of participants, the resulting judgment, to whether there will be uptake of results. Implicit approaches utilize qualitative methods and/or a simple voting structure of majority wins, and are used in informal consensus development methods and consensus development conferences. Explicit approaches aggregate results or judgments using explicit rules set a priori with definitions of “agreement” or consensus. Because the implicit process can be more opaque, unforeseen challenges can emerge such as the undue influence of a minority. And yet, the logistics of explicit approaches may be more time consuming and not appropriate when speed is a priority. In determining which method to use, it is important to understand the pros and cons of the different approaches and how it will affect the overall input, approach, and outcome. PMID

  10. Developing consensus criteria for sarcopenia: an update.

    PubMed

    McLean, Robert R; Kiel, Douglas P

    2015-04-01

    Sarcopenia, the age-related loss of muscle mass and strength, is a major cause of impaired physical function, which contributes to mobility disability, falls and hospitalizations in older adults. Lower muscle mass and strength are also associated with lower bone mineral density and greater risk for osteoporotic fractures. Thus, identification of sarcopenia could be important for fracture prevention as it may help improve fracture risk assessment, and muscle mass and strength can be improved with exercise, even among the frailest older adults. Unfortunately, there are no consensus diagnostic criteria for sarcopenia. Consequently there is no guidance to help clinicians identify older adults with clinically meaningful low muscle mass or weakness. Further, development of novel sarcopenia therapies is hindered not only due to the difficulty in identifying participants for clinical trials, and but also because there are no validated, clinically appropriate endpoints for assessment of treatment efficacy. There is currently a major push to establish a consensus definition of sarcopenia, and recent work holds promise that this goal may be within reach. This article discusses the evolution of the definition of sarcopenia, and focuses on the latest recommended diagnostic criteria proposed by the Foundation for the National Institutes of Health (FNIH) Sarcopenia Project. While these empirically-based cut-points for clinically important low muscle mass and weakness are a significant step forward for the sarcopenia field, important questions remain to be answered before consensus diagnostic criteria can be definitively established. Ongoing work to refine sarcopenia criteria will further advance the field and bring this important contributor to falls, fractures and disability into the mainstream of clinical care and ultimately lead to better quality of life with aging.

  11. Plan for early action: Recommendations

    SciTech Connect

    1998-12-31

    This report contains recommendations on the implementation of an action plan to reduce or recapture greenhouse gas (GHG) emissions in British Columbia. The report includes the consensus recommendations of the BC Greenhouse Gas Forum, as well as those items on which Forum participants have agreed to disagree, plus the reasons for those differences. The recommendations include: Umbrella actions which may affect several or all sectors of the economy, or support the success of other actions; actions to reduce vehicle kilometers travelled; actions to increase vehicle efficiency or increase the use of alternative fuels or technologies; actions to decrease GHG emissions from energy production; actions to increase end-use energy efficiency; and actions to reduce non-energy-related emissions. Appendices include work sheets on each action, with a description of the action and information on the action`s rationale, experience elsewhere, related policy initiatives, and key issues regarding feasibility and implementation.

  12. Implementation of molecular marker technologies in the apple rootstock breeding program in Geneva - challenges and successes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Geneva® Apple Rootstock Breeding program was initiated in the early 1970’s with the overarching goal of developing disease resistant, productive and precocious apple rootstocks. Near the turn of the century the program was joined with USDA ARS resources and in addition to focusing on releasing ...

  13. Phenotype harmonization and cross-study collaboration in GWAS consortia: the GENEVA experience.

    PubMed

    Bennett, Siiri N; Caporaso, Neil; Fitzpatrick, Annette L; Agrawal, Arpana; Barnes, Kathleen; Boyd, Heather A; Cornelis, Marilyn C; Hansel, Nadia N; Heiss, Gerardo; Heit, John A; Kang, Jae Hee; Kittner, Steven J; Kraft, Peter; Lowe, William; Marazita, Mary L; Monroe, Kristine R; Pasquale, Louis R; Ramos, Erin M; van Dam, Rob M; Udren, Jenna; Williams, Kayleen

    2011-04-01

    Genome-wide association study (GWAS) consortia and collaborations formed to detect genetic loci for common phenotypes or investigate gene-environment (G*E) interactions are increasingly common. While these consortia effectively increase sample size, phenotype heterogeneity across studies represents a major obstacle that limits successful identification of these associations. Investigators are faced with the challenge of how to harmonize previously collected phenotype data obtained using different data collection instruments which cover topics in varying degrees of detail and over diverse time frames. This process has not been described in detail. We describe here some of the strategies and pitfalls associated with combining phenotype data from varying studies. Using the Gene Environment Association Studies (GENEVA) multi-site GWAS consortium as an example, this paper provides an illustration to guide GWAS consortia through the process of phenotype harmonization and describes key issues that arise when sharing data across disparate studies. GENEVA is unusual in the diversity of disease endpoints and so the issues it faces as its participating studies share data will be informative for many collaborations. Phenotype harmonization requires identifying common phenotypes, determining the feasibility of cross-study analysis for each, preparing common definitions, and applying appropriate algorithms. Other issues to be considered include genotyping timeframes, coordination of parallel efforts by other collaborative groups, analytic approaches, and imputation of genotype data. GENEVA's harmonization efforts and policy of promoting data sharing and collaboration, not only within GENEVA but also with outside collaborations, can provide important guidance to ongoing and new consortia.

  14. A half century retrospective study of homicide-suicide in Geneva--Switzerland: 1956-2005.

    PubMed

    Shiferaw, Kebede; Burkhardt, Sandra; Lardi, Christelle; Mangin, Patrice; La Harpe, Romano

    2010-02-01

    This study provides a retrospective review from the forensic files of the University Centre of Legal Medicine in Western Switzerland in Geneva, from January 1956 to December 2005. The studied homicide-suicide cases cover a period of half a century (50 years). As a rule, all police-ordered forensic examinations of violent death cases in the Canton of Geneva are conducted by the University Centre of Legal Medicine. All of the data necessary for an exhaustive retrospective study are thus readily available. During the period covered in this work, 228 homicides were perpetrated in Geneva. In 23 cases, the homicide was followed by the suicide of the aggressor. The 34 victims of these homicides (18 women, 1 man and 15 children) had either an intimate or filial relationship with the perpetrator. Most of the suicidal perpetrators were men that killed their spouses or intimate partners, with children as additional victims in some cases. Shooting was the most common means to kill, followed by stabbing. The majority of the victims and perpetrators were Swiss nationals. This retrospective study shows that in the last 50 years, homicide-suicide cases in the Canton of Geneva have been a rare and an episodic phenomena with a very variable frequency from 1 year to another.

  15. Thirty Years of Influence: A Look Back at Geneva Smitherman's "Talkin and Testifyin"

    ERIC Educational Resources Information Center

    DoBell, Daniel C.

    2008-01-01

    Thirty years after its publication, Geneva Smitherman's seminal work, "Talkin and Testifyin" continues to influence scholars, policymakers and practitioners. This article takes a look at Smitherman's work by first providing an overview of the sociolinguistic theoretical foundations that led to its publication. This is followed by a reception…

  16. Evaluation of apple fruit aroma character from Geneva Malus core collection

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Mature apple fruit from 184 lines (41 species) from the Malus core and Kazakhstan collections of the germplasm repository at the New York Agricultural Experiment Station in Geneva, NY were evaluated. Volatile compounds, taste, weight, internal ethylene concentration, starch index, firmness, and Brix...

  17. Education for Internationalism at the Nordic School for Adult Education in Geneva 1931-1939

    ERIC Educational Resources Information Center

    Leppanen, Katarina

    2011-01-01

    Internationalism in the interwar era carried different meaning for different groups. A Nordic school for adult education, with the aim of raising the "international citizenship proficiency" of the Nordic peoples, was established in Geneva in 1931, through cooperation between representatives of international organisations and adult…

  18. Geneva apple rootstock performance in New York state and progress in commercialization

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A number of new apple rootstocks from the Cornell/USDA apple rootstock breeding project, located at Geneva NY which are resistant to the bacterial disease fire blight (Erwinia amylovora) are rapidly becoming available. Some named rootstock genotypes from this program have previously been tested in s...

  19. Parenting and Adolescent Identity: A Study of Indian Families in New Delhi and Geneva

    ERIC Educational Resources Information Center

    Sapru, Saloni

    2006-01-01

    This article examines the ancestral and acculturated cultural meanings in immigrant Indian parenting and adolescent identity using the independence-interdependence dimension as the focus. Forty Indian parents and their adolescents in Delhi, India, and Geneva, Switzerland, were interviewed using open-ended questions and scenarios. Adolescents also…

  20. ISPMD consensus on the management of premenstrual disorders

    PubMed Central

    O’Brien, Patrick Michael Shaughn; Bäckström, Torbjorn; Brown, Candace; Dennerstein, Lorraine; Endicott, Jean; Epperson, C. Neill; Eriksson, Elias; Freeman, Ellen W.; Halbreich, Uriel; Ismail, Khalid; Panay, Nicholas; Pearlstein, Teri; Rapkin, Andrea; Reid, Robert; Rubinow, David; Schmidt, Peter; Steiner, Meir; Studd, John; Sundström-Poromaa, Inger; Yonkers, Kimberly

    2014-01-01

    The second consensus meeting of the International Society for Premenstrual Disorders (ISPMD) took place in London during March 2011. The primary goal was to evaluate the published evidence and consider the expert opinions of the ISPMD members to reach a consensus on advice for the management of premenstrual disorders. Gynaecologists, psychiatrists, psychologists and pharmacologists each formally presented the evidence within their area of expertise; this was followed by an in-depth discussion leading to consensus recommendations. This article provides a comprehensive review of the outcomes from the meeting. The group discussed and agreed that careful diagnosis based on the recommendations and classification derived from the first ISPMD consensus conference is essential and should underlie the appropriate management strategy. Options for the management of premenstrual disorders fall under two broad categories, (a) those influencing central nervous activity, particularly the modulation of the neurotransmitter serotonin and (b) those that suppress ovulation. Psychotropic medication, such as selective serotonin reuptake inhibitors, probably acts by dampening the influence of sex steroids on the brain. Oral contraceptives, gonadotropin-releasing hormone agonists, danazol and estradiol all most likely function by ovulation suppression. The role of oophorectomy was also considered in this respect. Alternative therapies are also addressed, with, e.g. cognitive behavioural therapy, calcium supplements and Vitex agnus castus warranting further exploration. PMID:23624686

  1. Consensus Conference on North American Training in Hepatopancreaticobiliary Surgery: A Review of the Conference and Presentation of Consensus Statements.

    PubMed

    Jeyarajah, D R; Berman, R S; Doyle, M B; Geevarghese, S K; Posner, M C; Farmer, D; Minter, R M

    2016-04-01

    The findings and recommendations of the North American consensus conference on training in hepatopancreaticobiliary (HPB) surgery held in October 2014 are presented. The conference was hosted by the Society for Surgical Oncology (SSO), the Americas Hepato-Pancreatico-Biliary Association (AHPBA), and the American Society of Transplant Surgeons (ASTS). The current state of training in HPB surgery in North America was defined through three pathways-HPB, surgical oncology, and solid organ transplant fellowships. Consensus regarding programmatic requirements included establishment of minimum case volumes and inclusion of quality metrics. Formative assessment, using milestones as a framework and inclusive of both operative and nonoperative skills, must be present. Specific core HPB cases should be defined and used for evaluation of operative skills. The conference concluded with a focus on the optimal means to perform summative assessment to evaluate the individual fellow completing a fellowship in HPB surgery. Presentations from the hospital perspective and the American Board of Surgery led to consensus that summative assessment was desired by the public and the hospital systems and should occur in a uniform but possibly modular manner for all HPB fellowship pathways. A task force composed of representatives of the SSO, AHPBA, and ASTS are charged with implementation of the consensus statements emanating from this consensus conference.

  2. C3 glomerulopathy: consensus report.

    PubMed

    Pickering, Matthew C; D'Agati, Vivette D; Nester, Carla M; Smith, Richard J; Haas, Mark; Appel, Gerald B; Alpers, Charles E; Bajema, Ingeborg M; Bedrosian, Camille; Braun, Michael; Doyle, Mittie; Fakhouri, Fadi; Fervenza, Fernando C; Fogo, Agnes B; Frémeaux-Bacchi, Véronique; Gale, Daniel P; Goicoechea de Jorge, Elena; Griffin, Gene; Harris, Claire L; Holers, V Michael; Johnson, Sally; Lavin, Peter J; Medjeral-Thomas, Nicholas; Paul Morgan, B; Nast, Cynthia C; Noel, Laure-Hélène; Peters, D Keith; Rodríguez de Córdoba, Santiago; Servais, Aude; Sethi, Sanjeev; Song, Wen-Chao; Tamburini, Paul; Thurman, Joshua M; Zavros, Michael; Cook, H Terence

    2013-12-01

    C3 glomerulopathy is a recently introduced pathological entity whose original definition was glomerular pathology characterized by C3 accumulation with absent or scanty immunoglobulin deposition. In August 2012, an invited group of experts (comprising the authors of this document) in renal pathology, nephrology, complement biology, and complement therapeutics met to discuss C3 glomerulopathy in the first C3 Glomerulopathy Meeting. The objectives were to reach a consensus on: the definition of C3 glomerulopathy, appropriate complement investigations that should be performed in these patients, and how complement therapeutics should be explored in the condition. This meeting report represents the current consensus view of the group.

  3. The Same Language Speak We Do - Consensus Terminology for Telehealth.

    PubMed

    Scott, Richard E; Mars, Maurice

    2016-01-01

    e-Health has grown to become interjurisdictional in scope and in practice. Central to successful implementation and scaling of e-heath solutions is clear and concise communication of ideas and principles, and instructions during construction. This paper addresses the need for an agreed taxonomy and terminology and focuses on explaining, proposing, and recommending terms and action for an international consensus-based terminology for telehealth.

  4. Public health importance and risk factors for cercarial dermatitis associated with swimming in Lake Leman at Geneva, Switzerland.

    PubMed

    Chamot, E; Toscani, L; Rougemont, A

    1998-06-01

    Fifteen cohorts of healthy bathers were recruited at four Lake Leman beaches between 3 July and 23 August 1996 to assess the public health importance of cercarial dermatitis in Geneva, Switzerland. Telephone follow-up interviews were carried out after 2-7 days. Overall, 153 bathers out of 555 reported probable cercarial dermatitis at follow-up. Median daily attack rate was 27.7% (2.2-57.7%). Of the cases, 11.1% noticed more than 30 skin lesions, 19.6% described severe itching, 50.3% used a drug treatment, 3.9% visited a doctor and 15% claimed they would reduce their bathing activities. History of cercarial dermatitis, time spent in the water, hour of the day, barometric pressure and maximum daily atmospheric temperature predicted disease occurrence in multivariate analysis. While a benign disease, cercarial dermatitis may have a negative impact on the local water recreation industry. The identification of risk factors for the disease may help produce better preventive recommendations for the bathers.

  5. European consensus conference on faecal microbiota transplantation in clinical practice.

    PubMed

    Cammarota, Giovanni; Ianiro, Gianluca; Tilg, Herbert; Rajilić-Stojanović, Mirjana; Kump, Patrizia; Satokari, Reetta; Sokol, Harry; Arkkila, Perttu; Pintus, Cristina; Hart, Ailsa; Segal, Jonathan; Aloi, Marina; Masucci, Luca; Molinaro, Antonio; Scaldaferri, Franco; Gasbarrini, Giovanni; Lopez-Sanroman, Antonio; Link, Alexander; de Groot, Pieter; de Vos, Willem M; Högenauer, Christoph; Malfertheiner, Peter; Mattila, Eero; Milosavljević, Tomica; Nieuwdorp, Max; Sanguinetti, Maurizio; Simren, Magnus; Gasbarrini, Antonio

    2017-04-01

    Faecal microbiota transplantation (FMT) is an important therapeutic option for Clostridium difficile infection. Promising findings suggest that FMT may play a role also in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance. In view of this, an evidence-based recommendation is needed to drive the practical implementation of FMT. In this European Consensus Conference, 28 experts from 10 countries collaborated, in separate working groups and through an evidence-based process, to provide statements on the following key issues: FMT indications; donor selection; preparation of faecal material; clinical management and faecal delivery and basic requirements for implementing an FMT centre. Statements developed by each working group were evaluated and voted by all members, first through an electronic Delphi process, and then in a plenary consensus conference. The recommendations were released according to best available evidence, in order to act as guidance for physicians who plan to implement FMT, aiming at supporting the broad availability of the procedure, discussing other issues relevant to FMT and promoting future clinical research in the area of gut microbiota manipulation. This consensus report strongly recommends the implementation of FMT centres for the treatment of C. difficile infection as well as traces the guidelines of technicality, regulatory, administrative and laboratory requirements.

  6. [3rd Hungarian Breast Cancer Consensus Conference - Surgery Guidelines].

    PubMed

    Lázár, György; Bursics, Attila; Farsang, Zoltán; Harsányi, László; Kósa, Csaba; Maráz, Róbert; Mátrai, Zoltán; Paszt, Attila; Pavlovics, Gábor; Tamás, Róbert

    2016-09-01

    Therapy for breast cancer today is characterised by ever more precise diagnostic methods and ever more effective oncological treatments, a trend which will certainly continue in the future. Breast preservation and the application of oncoplastic principles are increasingly popular. A sentinel lymph node biopsy in the surgical treatment of the axilla is primary, with the indication for axillary block dissection (ABD) narrowing and radiation therapy becoming an alternative to ABD in certain cases. This publication summarises our recommendations on the surgical treatment of breast cancer based on the content of the 2nd Breast Cancer Consensus Conference and considering the latest international studies and professional recommendations.

  7. Diagnosis and management of acute appendicitis. EAES consensus development conference 2015.

    PubMed

    Gorter, Ramon R; Eker, Hasan H; Gorter-Stam, Marguerite A W; Abis, Gabor S A; Acharya, Amish; Ankersmit, Marjolein; Antoniou, Stavros A; Arolfo, Simone; Babic, Benjamin; Boni, Luigi; Bruntink, Marlieke; van Dam, Dieuwertje A; Defoort, Barbara; Deijen, Charlotte L; DeLacy, F Borja; Go, Peter Mnyh; Harmsen, Annelieke M K; van den Helder, Rick S; Iordache, Florin; Ket, Johannes C F; Muysoms, Filip E; Ozmen, M Mahir; Papoulas, Michail; Rhodes, Michael; Straatman, Jennifer; Tenhagen, Mark; Turrado, Victor; Vereczkei, Andras; Vilallonga, Ramon; Deelder, Jort D; Bonjer, Jaap

    2016-11-01

    Unequivocal international guidelines regarding the diagnosis and management of patients with acute appendicitis are lacking. The aim of the consensus meeting 2015 of the EAES was to generate a European guideline based on best available evidence and expert opinions of a panel of EAES members. After a systematic review of the literature by an international group of surgical research fellows, an expert panel with extensive clinical experience in the management of appendicitis discussed statements and recommendations. Statements and recommendations with more than 70 % agreement by the experts were selected for a web survey and the consensus meeting of the EAES in Bucharest in June 2015. EAES members and attendees at the EAES meeting in Bucharest could vote on these statements and recommendations. In the case of more than 70 % agreement, the statement or recommendation was defined as supported by the scientific community. Results from both the web survey and the consensus meeting in Bucharest are presented as percentages. In total, 46 statements and recommendations were selected for the web survey and consensus meeting. More than 232 members and attendees voted on them. In 41 of 46 statements and recommendations, more than 70 % agreement was reached. All 46 statements and recommendations are presented in this paper. They comprise topics regarding the diagnostic work-up, treatment indications, procedural aspects and post-operative care. The consensus meeting produced 46 statements and recommendations on the diagnostic work-up and management of appendicitis. The majority of the EAES members supported these statements. These consensus proceedings provide additional guidance to surgeons and surgical residents providing care to patients with appendicitis.

  8. Report from the 13th annual Western canadian gastrointestinal cancer consensus conference; calgary, alberta; september 8-10, 2011.

    PubMed

    Vickers, M M; Pasieka, J; Dixon, E; McEwan, S; McKay, A; Renouf, D; Schellenberg, D; Ruether, D

    2012-12-01

    The 13th annual Western Canadian Gastrointestinal Cancer Consensus Conference was held in Calgary, Alberta, September 8-10, 2011. Health care professionals involved in the care of patients with gastrointestinal cancers participated in presentation and discussion sessions for the purposes of developing the recommendations presented here. This consensus statement addresses current issues in the management neuroendocrine tumours and locally advanced pancreatic cancer.

  9. International consensus on allergy immunotherapy.

    PubMed

    Jutel, Marek; Agache, Ioana; Bonini, Sergio; Burks, A Wesley; Calderon, Moises; Canonica, Walter; Cox, Linda; Demoly, Pascal; Frew, Antony J; O'Hehir, Robin; Kleine-Tebbe, Jörg; Muraro, Antonella; Lack, Gideon; Larenas, Désirée; Levin, Michael; Nelson, Harald; Pawankar, Ruby; Pfaar, Oliver; van Ree, Ronald; Sampson, Hugh; Santos, Alexandra F; Du Toit, George; Werfel, Thomas; Gerth van Wijk, Roy; Zhang, Luo; Akdis, Cezmi A

    2015-09-01

    Allergen immunotherapy (AIT) has been used to treat allergic disease since the early 1900s. Despite numerous clinical trials and meta-analyses proving AIT efficacious, it remains underused and is estimated to be used in less than 10% of patients with allergic rhinitis or asthma worldwide. In addition, there are large differences between regions, which are not only due to socioeconomic status. There is practically no controversy about the use of AIT in the treatment of allergic rhinitis and allergic asthma, but for atopic dermatitis or food allergy, the indications for AIT are not well defined. The elaboration of a wider consensus is of utmost importance because AIT is the only treatment that can change the course of allergic disease by preventing the development of asthma and new allergen sensitizations and by inducing allergen-specific immune tolerance. Safer and more effective AIT strategies are being continuously developed both through elaboration of new allergen preparations and adjuvants and alternate routes of administration. A number of guidelines, consensus documents, or both are available on both the international and national levels. The international community of allergy specialists recognizes the need to develop a comprehensive consensus report to harmonize, disseminate, and implement the best AIT practice. Consequently, the International Collaboration in Asthma, Allergy and Immunology, formed by the European Academy of Allergy and Clinical Immunology; the American Academy of Allergy, Asthma & Immunology; the American College of Allergy, Asthma & Immunology; and the World Allergy Organization, has decided to issue an international consensus on AIT.

  10. Confrontation--Catalyst for Consensus.

    ERIC Educational Resources Information Center

    Barnett, Vincent M., Jr.

    The main question discussed in this paper is whether the confrontations which have been taking place on college campuses these past few years provide the basis for a new consensus which will enable all to move forward with confidence and a renewed sense of achievement. In discussing these confrontations, however, several fallacies need to be…

  11. [Recommendations for respiratory support in the newborn].

    PubMed

    2012-10-01

    The recommendations included in this document will be part a series of updated reviews of the literature on respiratory support in the newborn infant. These recommendations are structured into twelve modules, with modules 4, 5, and 6 presented here. Each module is the result of a consensus process of all members of the Surfactant and Respiratory Group of the Spanish Society of Neonatology. They represent a summary of the published papers on each specific topic, and of the clinical experience of each one of the members of the group. Each module includes a summary of the scientific evidence available, graded into 4 levels of recommendations.

  12. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up.

    PubMed

    Colombo, N; Creutzberg, C; Amant, F; Bosse, T; González-Martín, A; Ledermann, J; Marth, C; Nout, R; Querleu, D; Mirza, M R; Sessa, C

    2016-01-01

    The first joint European Society for Medical Oncology (ESMO), European SocieTy for Radiotherapy & Oncology (ESTRO) and European Society of Gynaecological Oncology (ESGO) consensus conference on endometrial cancer was held on 11-13 December 2014 in Milan, Italy, and comprised a multidisciplinary panel of 40 leading experts in the management of endometrial cancer. Before the conference, the expert panel prepared three clinically relevant questions about endometrial cancer relating to the following four areas: prevention and screening, surgery, adjuvant treatment and advanced and recurrent disease. All relevant scientific literature, as identified by the experts, was reviewed in advance. During the consensus conference, the panel developed recommendations for each specific question and a consensus was reached. Results of this consensus conference, together with a summary of evidence supporting each recommendation, are detailed in this article. All participants have approved this final article.

  13. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: Diagnosis, Treatment and Follow-up.

    PubMed

    Colombo, Nicoletta; Creutzberg, Carien; Amant, Frederic; Bosse, Tjalling; González-Martín, Antonio; Ledermann, Jonathan; Marth, Christian; Nout, Remi; Querleu, Denis; Mirza, Mansoor Raza; Sessa, Cristiana

    2016-01-01

    The first joint European Society for Medical Oncology (ESMO), European SocieTy for Radiotherapy & Oncology (ESTRO) and European Society of Gynaecological Oncology (ESGO) consensus conference on endometrial cancer was held on 11-13 December 2014 in Milan, Italy, and comprised a multidisciplinary panel of 40 leading experts in the management of endometrial cancer. Before the conference, the expert panel prepared three clinically-relevant questions about endometrial cancer relating to the following four areas: prevention and screening, surgery, adjuvant treatment and advanced and recurrent disease. All relevant scientific literature, as identified by the experts, was reviewed in advance. During the consensus conference, the panel developed recommendations for each specific question and a consensus was reached. Results of this consensus conference, together with a summary of evidence supporting each recommendation, are detailed in this article. All participants have approved this final article.

  14. [All-Russian Consensus on Diagnosis and Treatment of Celiac Disease in Children and Adults].

    PubMed

    Parfenov, A I; Bykova, S V; Sabel'nikova, E A; Maev, I V; Baranov, A A; Bakulin, I G; Krums, L M; Bel'mer, S V; Borovik, T E; Zakharova, I N; Dmitrieva, Yu A; Roslavtseva, E A; Kornienko, E A; Khavkin, A I; Potapov, A S; Revnova, M O; Mukhina, Yu G; Shcherbakov, P L; Fedorov, E D; Belousova, E A; Khalif, I L; Khomeriki, S G; Rotin, D L; Vorob'eva, N G; Pivnik, A V; Gudkova, R B; Chernin, V V; Vokhmyanina, N V; Pukhlikova, T V; Degtyarev, D A; Damulin, I V; Mkrtumyan, A M; Dzhulai, G S; Tetruashvili, N K; Baranovsky, A Yu; Nazarenko, L I; Kharitonov, A G; Loranskaya, I D; Saifutdinov, R G; Livzan, M A; Abramov, D A; Osipenko, M F; Oreshko, L V; Tkachenko, E I; Sitkin, S I; Efremov, L I

    2017-01-01

    The paper presents the All-Russian consensus on the diagnosis and treatment of celiac disease in children and adults, which has been elaborated by leading experts, such as gastroenterologists and pediatricians of Russia on the basis of the existing Russian and international guidelines. The consensus approved at the 42nd Annual Scientific Session of the Central Research Institute of Gastroenterology on Principles of Evidence-Based Medicine into Clinical Practice (March 2-3, 2016). The consensus is intended for practitioners engaged in the management and treatment of patients with celiac disease. Evidence for the main provisions of the consensus was sought in electronic databases. In making recommendations, the main source was the publications included in the Cochrane Library, EMBASE, MEDLINE, and PubMed. The search depth was 10 years. Recommendations in the preliminary version were reviewed by independent experts. Voting was done by the Delphic polling system.

  15. Consensus statement on the treatment of multiple sclerosis by the Spanish Society of Neurology in 2016.

    PubMed

    García Merino, A; Ramón Ara Callizo, J; Fernández Fernández, O; Landete Pascual, L; Moral Torres, E; Rodríguez-Antigüedad Zarrantz, A

    2017-03-01

    With the advent of new disease-modifying drugs, the treatment of multiple sclerosis is becoming increasingly complex. Using consensus statements is therefore advisable. The present consensus statement, which was drawn up by the Spanish Society of Neurology's study group for demyelinating diseases, updates previous consensus statements on the disease. The present study lists the medications currently approved for multiple sclerosis and their official indications, and analyses such treatment-related aspects as activity, early treatment, maintenance, follow-up, treatment failure, changes in medication, and special therapeutic situations. This consensus statement includes treatment recommendations for a wide range of demyelinating diseases, from isolated demyelinating syndromes to the different forms of multiple sclerosis, as well as recommendations for initial therapy and changes in drug medication, and additional comments on induction and combined therapy and practical aspects of the use of these drugs.

  16. ESMO-ESGO-ESTRO consensus conference on endometrial cancer: Diagnosis, treatment and follow-up.

    PubMed

    Colombo, Nicoletta; Creutzberg, Carien; Amant, Frederic; Bosse, Tjalling; González-Martín, Antonio; Ledermann, Jonathan; Marth, Christian; Nout, Remi; Querleu, Denis; Mirza, Mansoor Raza; Sessa, Cristiana

    2015-12-01

    The first joint European Society for Medical Oncology (ESMO), European SocieTy for Radiotherapy & Oncology (ESTRO) and European Society of Gynaecological Oncology (ESGO) consensus conference on endometrial cancer was held on 11-13 December 2014 in Milan, Italy, and comprised a multidisciplinary panel of 40 leading experts in the management of endometrial cancer. Before the conference, the expert panel prepared three clinically-relevant questions about endometrial cancer relating to the following four areas: Prevention and screening, surgery, adjuvant treatment and advanced and recurrent disease. All relevant scientific literature, as identified by the experts, was reviewed in advance. During the consensus conference, the panel developed recommendations for each specific question and a consensus was reached. Results of this consensus conference, together with a summary of evidence supporting each recommendation, are detailed in this article. All participants have approved this final article.

  17. Executive Summary: European Heart Rhythm Association Consensus Document on the Management of Supraventricular Arrhythmias

    PubMed Central

    Katritsis, Demosthenes G; Boriani, Giuseppe; Cosio, Francisco G; Jais, Pierre; Hindricks, Gerhard; Josephson, Mark E; Keegan, Roberto; Knight, Bradley P; Kuck, Karl-Heinz; Lane, Deirdre A; Lip, Gregory YH; Malmborg, Helena; Oral, Hakan; Pappone, Carlo; Themistoclakis, Sakis; Wood, Kathryn A.; Young-Hoon, Kim; Lundqvist, Carina Blomström

    2016-01-01

    This paper is an executive summary of the full European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, published in Europace. It summarises developments in the field and provides recommendations for patient management, with particular emphasis on new advances since the previous European Society of Cardiology guidelines. The EHRA consensus document is available to read in full at http://europace.oxfordjournals.org PMID:28116087

  18. Interdisciplinary consensus document for the treatment of fibromyalgia.

    PubMed

    de Miquel, C Alegre; Campayo, J García; Flórez, M Tomás; Arguelles, J M Gómez; Tarrio, E Blanco; Montoya, M Gobbo; Martin, Á Pérez; Salio, A Martínez; Fuentes, J Vidal; Alberch, E Altarriba; de la Cámara, A Gómez

    2010-01-01

    Backgrounds. The elevated prevalence and enormous clinical and social impact of fibromyalgia, together with the complexity of its treatment, require action consensuses that guide health care professionals. Although there are some similar documents in our language, most have been made from the perspective of a single discipline.Objective. To develop a consensus on the treatment of fibromyalgia made by selected representatives and supported by the principal medical associations that intervene in its treatment (rheumatology, neurology, psychiatry,rehabilitation and family medicine) and representatives of the associations of patients. On the other hand, understanding the disease not as a homogenous disorders but also as the sum of different clinical subtypes,having specific symptomatic characteristics and different therapeutic needs is stressed. This approach represented a need perceived by the clinicians and a novelty regarding previous consensuses.Methods. The different clinical classifications proposed in fibromyalgia and the scientific evidence of the treatments used in this disease were reviewed. For the selection of the classification used and performance of the therapeutic recommendations, some of the usual techniques to obtain the consensus (nominal group and brainstorming) were used.Conclusion. The classification of Giesecke of fibromyalgia into 3 subgroups seems to have the greatest scientific evidence and the most useful for the clinician. The guide offers a series of general recommendations for all the patients with fibromyalgia. However, in addition, for each subgroup, there are a series of specific pharmacological and psychological-type recommendations and those of modification of the environment, which will make it possible to have a personalized approach to the patient with fibromyalgia in accordance with their individual clinical characteristics (pain, catastrophizing levels, etc.).

  19. The International Xenotransplantation Association consensus statement on conditions for undertaking clinical trials of xenocorneal transplantation.

    PubMed

    Kim, Mee Kum; Choi, Hyuk Jin; Kwon, Ivo; Pierson, Richard N; Cooper, David K C; Soulillou, Jean-Paul; O'Connell, Philip J; Vabres, Bertrand; Maeda, Naoyuki; Hara, Hidetaka; Scobie, Linda; Gianello, Pierre; Takeuchi, Yasuhiro; Yamada, Kazuhiko; Hwang, Eung-Soo; Kim, Sang Joon; Park, Chung-Gyu

    2014-01-01

    To develop an international consensus regarding the appropriate conditions for undertaking clinical trials in xenocorneal transplantation, here we review specific ethical, logistical, scientific, and regulatory issues regarding xenocorneal transplantation, and propose guidelines for conduct of clinical xenocorneal transplantation trials. These proposed guidelines are modeled on the published consensus statement of the International Xenotransplantation Association regarding recommended guidelines for conduct of clinical islet xenotransplantation. It is expected that this initial consensus statement will be revised over time in response to scientific advances in the field, and changes in the regulatory framework based on accumulating clinical experience.

  20. The Upper Laacher See Tephra in Lake Geneva sediments: Paleoenvironmental and paleoclimatological implications

    USGS Publications Warehouse

    Moscariello, A.; Costa, F.

    1997-01-01

    Microstratigraphical analysis of Late glacial lacustrine sediments from Geneva Bay provided evidence of a tephra layer within the upper Aller??d biozone. The layer consists of alkali feldspar, quartz, plagioclase. amphibole, pyroxene, opaques, titanite and glass shards. Electron microprobe analyses and morphological study of glass shards allowed correlation with the upper part of the Laacher See Tephra of the Laacher See volcano (Eifel Mountains, Germany). Sedimentological features of enclosing lacustrine sediments suggest that a momentary decrease in precipitation occurred in the catchment area and consequent reduction in detrital supply in the lake, after the ash fall-out. This has been interpreted as the environmental response to a momentary cooling following the Laacher See Tephra aerosols emission. Comparison with Sedimentological features characterizing the Aller??d-Younger Dryas transition highlights the sensitivity of Lake Geneva system in recording both short and long-terms climate-induced environmental changes.

  1. Immunization Status of Young People Attending a Youth Clinic in Geneva, Switzerland.

    PubMed

    Meynard, Anne; Genequand, Lydia Markham; Jeannot, Emilien; Wyler-Lazarevic, Claire-Anne; Cerutti, Bernard; Narring, Françoise

    2016-04-01

    Adolescent vaccination coverage is very variable in European countries and data are scarce. The aim of this study was to assess immunization status and analyze potential variations according to sociodemographic variables in a youth clinic in Geneva, Switzerland. Immunization status was assessed retrospectively: Tetanus (number of doses or in absence of data tetanus antibodies) and measles as indicators of childhood coverage as well as hepatitis B and human papillomavirus. All new patients (N = 390) of Geneva University Hospital's youth clinic were included between January 2010 and June 2011. Vaccine coverage was low for all vaccines regardless of sex or origin. 89% of young people tested (mostly recent immigrants with no available data) had tetanus antibodies indicating adequate childhood immunization but hepatitis B and HPV coverage was low especially in recent immigrants. Systematic assessment allows better adolescent vaccine coverage and can improve safety by avoiding unnecessary dosis.

  2. [Incidence of major lower limb amputation in Geneva: twenty-one years of observation].

    PubMed

    Carmona, G A; Lacraz, A; Hoffmeyer, P; Assal, M

    2014-10-22

    Between 1990 and 2010 the incidence of major lowerlimb amputations (by definition any level of amputation above the foot) in the canton of Geneva was 10.02 per 100,000 inhabitants/ year. The analysis of various population groups revealed that the presence of diabetes increased the relative risk of amputation by a factor of 20, and age 65 years or older by a factor of 9. During this 21 years period we observed a gradual decline in the incidence of amputation and an increased age at the time of amputation, despite the increasing prevalence of diabetes and an aging population. This was a reflection on the efforts of primary and secon- dary prevention, initiated in the 1980s in which Geneva was a pioneer.

  3. A healthy bladder: a consensus statement.

    PubMed

    Lukacz, E S; Sampselle, C; Gray, M; Macdiarmid, S; Rosenberg, M; Ellsworth, P; Palmer, M H

    2011-10-01

    A panel of experts in urology, urogynecology, nursing, and behavioral therapy convened in 2010 to discuss the importance of a healthy bladder on overall health. They determined that a consensus statement was necessary to raise awareness among the general public, healthcare providers, payors, and policymakers, with the goals of minimizing the impact of poor bladder health and stimulating primary prevention of bladder conditions. In this statement, 'healthy' bladder function is described, as well as internal and external factors that influence bladder health. It is suggested that primary prevention strategies should be aimed at providing education regarding normal lower urinary tract structures and functioning to the public, including patients and healthcare providers. This education may promote the achievement of optimal bladder health by increasing healthy bladder habits and behaviors, awareness of risk factors, healthcare seeking, and clinician engagement and reducing stigma and other barriers to treatment. Promoting optimal bladder health may reduce the personal, societal and economic impact of bladder conditions, including anxiety and depression and costs associated with conditions or diseases and their treatment. While adopting healthy bladder habits and behaviors and behaviors may improve or maintain bladder health, it is important to recognize that certain symptoms may indicate the presence of conditions that require medical attention; many bladder conditions are treatable with a range of options for most bladder conditions. Lastly, the authors propose clinical directives based on persuasive and convergent research to improve and maintain bladder health. The authors hope that this statement will lead to promotion and achievement of optimal bladder health, which may improve overall health and help minimize the effects of bladder conditions on the public, healthcare professionals, educators, employers, and payors. The advisors are in consensus regarding the

  4. Case definitions integrating empiric and consensus perspectives

    PubMed Central

    Jason, Leonard A.; McManimen, Stephanie; Sunnquist, Madison; Brown, Abigail; Furst, Jacob; Newton, Julia L.; Strand, Elin Bolle

    2016-01-01

    Background There has been considerable controversy regarding how to name and define the illnesses known as myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS). The IOM report has proposed a new clinical criteria and name for this illness, but aspects of these recommendations have been scrutinized by patients and scientists. Purpose It is possible that both empiric and consensus approaches could be used to help settle some of these diagnostic challenges. Using patient samples collected in the United States, Great Britain, and Norway (N=556), the current study attempted to categorize patients using more general as well as more restricted case definitions. Results Overall, the outcomes suggest that there might be four groupings of patients, with the broadest category involving those with chronic fatigue (N=62), defined by 6 or more months of fatigue which can be cannot be explained by medical or psychiatric conditions. A second category involves those patients that have chronic fatigue that can be explained by a medical or psychiatric condition (N=47). A third category involves more specific criteria that have been posited both by the IOM report, a Canadian Clinical Case criteria, a ME-ICC criteria and a more empiric approach. These efforts have specified domains of substantial reductions of activity, post-exertional malaise, neurocognitive impairment, and sleep dysfunction (N=346). Patients with these characteristics were more functionally impaired than those meeting just chronic fatigue criteria, p < .05. Finally, those meeting even more restrictive ME criteria proposed by Ramsay, identified a smaller and even more impaired group, p < .05. Discussion The advantages of using such empirical and consensus approaches to develop reliable classification and diagnostic efforts are discussed. PMID:27088059

  5. In America’s Best Interests: 1977 Additional Protocol I to the Geneva Conventions, Redux

    DTIC Science & Technology

    2005-05-01

    34 "[i]ts aim... to limit the effects of hostilities and to alleviate suffering."l The Protocols Additional (I and II) to the famous 1949 Geneva...admittedly demands vision, political will, and even courage. The Impetus for the Protocols The United States, in keeping with its history ofleadership ... effects -- it would grant Prisoner of War (POW) status to bomb-carrying terrorists disguised as harmless civilians. II Due to the spinelessness of the

  6. Robust control system for the new 1.2-m telescopes of the Geneva Observatory

    NASA Astrophysics Data System (ADS)

    Russiniello, Giovanni B.; Huguenin, Daniel; Wildi, Francois P.

    2000-06-01

    This paper presents the distributed hardware and software architecture of this 1.2-meter telescope control system, entirely designed and built by the Geneva Observatory. The modular concept and the choices of hardware tested in industrial automation made it possible to obtain great operational robustness and guarantee for long-term maintenance. The adopted solution is based on a transputer tree-network. The interactions between telescope and observer are transparent and completely integrated in the observation software of the attached instrument.

  7. Profiles of international archives: Les archives Jean Piaget, University of Geneva, Switzerland.

    PubMed

    Burman, Jeremy Trevelyan

    2013-05-01

    This research report provides a look behind closed doors at the Jean Piaget Archives in Geneva, Switzerland. It situates the potential visitor, contextualizes the Archives in its own history, and then describes what scholars can expect to find. New details about Piaget's views on Equal Rights and Equal Pay are also provided, including a look at how they affected the women who worked his factory (esp. Bärbel Inhelder). (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  8. Cost Sensitive Moving Target Consensus

    SciTech Connect

    Duan, Sisi; Li, Yun; Levitt, Karl N.

    2016-01-01

    Consensus is a fundamental approach to implementing fault-tolerant services through replication where there exists a tradeoff between the cost and the resilience. For instance, Crash Fault Tolerant (CFT) protocols have a low cost but can only handle crash failures while Byzantine Fault Tolerant (BFT) protocols handle arbitrary failures but have a higher cost. Hybrid protocols enjoy the benefits of both high performance without failures and high resiliency under failures by switching among different subprotocols. However, it is challenging to determine which subprotocols should be used. We propose a moving target approach to switch among protocols according to the existing system and network vulnerability. At the core of our approach is a formalized cost model that evaluates the vulnerability and performance of consensus protocols based on real-time Intrusion Detection System (IDS) signals. Based on the evaluation results, we demonstrate that a safe, cheap, and unpredictable protocol is always used and a high IDS error rate can be tolerated.

  9. Report of the Joint ILO/UNESCO Committee of Experts on the Application of the Recommendation Concerning the Status of Teachers.

    ERIC Educational Resources Information Center

    International Labour Office, Geneva (Switzerland).

    This report is an examination of implementation efforts in reference to the Recommendation Concerning the Status of Teachers, set up in pursuance to decisions taken at the 14th Session of the General Conference of UNESCO (Paris, Oct.-Nov. 1966) and the 167th Session of the Governing Body of the International Labour Office (ILO) (Geneva, Nov.…

  10. [Consensus for the prevention of cervical cancer in Mexico].

    PubMed

    Kably Ambe, Alberto; Ruiz Moreno, José Antonio; Ponce, Eduardo Lazcano; Vargas Hernández, Victor Manuel; Aguado Pérez, Rogelio A; Alonso de Ruiz, Patricia

    2011-12-01

    Cervical cancer remains a serious public health problem in the world; that is why the Mexican Federation of Schools of Obstetrics and Gynecology convened the elaboration of a consensus that is devoted this number of Ginecologia y Obstetricia de Mexico. In recent years has strengthened perceptions (public and private) in the need for preventive strategies in the medium and long terms. The development of effective vaccines against the human papilloma virus and the application of new methods of detection from viral DNA (completely automated for personal application) allow some degree of optimism. It is proposed a consensus with general recommendations in two consecutive stages: (a) primary prevention consisting of education for the prevention of cervical cancer and universal immunization and (b) secondary prevention by early detection of infections or injuries that could favor carcinogenesis. The consensus reviewed characteristics of available vaccines in detail and proposes strategies for implementation in Mexican population. Also, check out main methods of early detection of infection (or predisposing lesions) and suggests public and private strategies for implementation. Consensus places particular emphasis on early immunization for female population and correct use of methods for detection of infections or injuries that might cause cervical cancer.

  11. Energy strategy: Roadmap to consensus

    SciTech Connect

    Not Available

    1990-11-01

    The United States lacks a comprehensive approach to policy-making in the energy realm. Today, as in the past, individual constituency groups tend to focus on their particular aspect of the energy challenge. Many employ a ``decide-announce-defend`` approach to policy-making, setting out to secure a unilateral advantage for themselves. By so doing, they inevitably pit interest against interest. The result is a polarization of constituencies, and shortsighted policies designed to address the issue of the moment. The American Energy Assurance Council (AEAC) is a non-profit organization founded in 1987 for the sole purpose of facilitating progress toward a fair efficient wise, stable, and consensus-based national energy strategy. AEAC does not have a substantive policy agencies. Rather, we are committed to supporting a process whereby the many stakeholders and policy makers concerned with energy-related issues can come together in productive discourse, thereby overcoming ignorance of each other`s positions. The Council seeks to act as a facilitative body, providing a ``safe`` context for inventive and creative thinking. We attempt to build a store of common knowledge, and to build on that store according to mutually agreed-upon groundrules, and employing sophisticated approaches to facilitation and mediation. This report, the National Energy Consensus Experiment (NECE), was an ambitious experiment in consensus-building. We learned a great deal from it, both in terms of substance and process, and we are convinced that it holds important lessons for others who may seek to build consensus in the public policy realm.

  12. Energy strategy: Roadmap to consensus

    SciTech Connect

    Not Available

    1990-11-01

    The United States lacks a comprehensive approach to policy-making in the energy realm. Today, as in the past, individual constituency groups tend to focus on their particular aspect of the energy challenge. Many employ a decide-announce-defend'' approach to policy-making, setting out to secure a unilateral advantage for themselves. By so doing, they inevitably pit interest against interest. The result is a polarization of constituencies, and shortsighted policies designed to address the issue of the moment. The American Energy Assurance Council (AEAC) is a non-profit organization founded in 1987 for the sole purpose of facilitating progress toward a fair efficient wise, stable, and consensus-based national energy strategy. AEAC does not have a substantive policy agencies. Rather, we are committed to supporting a process whereby the many stakeholders and policy makers concerned with energy-related issues can come together in productive discourse, thereby overcoming ignorance of each other's positions. The Council seeks to act as a facilitative body, providing a safe'' context for inventive and creative thinking. We attempt to build a store of common knowledge, and to build on that store according to mutually agreed-upon groundrules, and employing sophisticated approaches to facilitation and mediation. This report, the National Energy Consensus Experiment (NECE), was an ambitious experiment in consensus-building. We learned a great deal from it, both in terms of substance and process, and we are convinced that it holds important lessons for others who may seek to build consensus in the public policy realm.

  13. American Burn Association Consensus Statements

    DTIC Science & Technology

    2013-08-01

    finally allow us to follow the ACS program in bariatric surgery and link quality-based purchasing with verification. For this col- laborative...University of Washington Medicine Department of Surgery , Seattle, Washington. See under consensus statements for author affiliations. The 2012 ABA burn...correspondence to Nicole S. Gibran MD, FACS, UW Medicine Regional Burn Center, UW Medicine Department of Surgery , Seattle, Washington 98104. Copyright

  14. Scab resistance in 'Geneva' apple is conditioned by a resistance gene cluster with complex genetic control.

    PubMed

    Bastiaanse, Héloïse; Bassett, Heather C M; Kirk, Christopher; Gardiner, Susan E; Deng, Cecilia; Groenworld, Remmelt; Chagné, David; Bus, Vincent G M

    2016-02-01

    Apple scab, caused by the fungal pathogen Venturia inaequalis, is one of the most severe diseases of apple worldwide. It is the most studied plant-pathogen interaction involving a woody species using modern genetic, genomic, proteomic and bioinformatic approaches in both species. Although 'Geneva' apple was recognized long ago as a potential source of resistance to scab, this resistance has not been characterized previously. Differential interactions between various monoconidial isolates of V. inaequalis and six segregating F1 and F2 populations indicate the presence of at least five loci governing the resistance in 'Geneva'. The 17 chromosomes of apple were screened using genotyping-by-sequencing, as well as single marker mapping, to position loci controlling the V. inaequalis resistance on linkage group 4. Next, we fine mapped a 5-cM region containing five loci conferring both dominant and recessive scab resistance to the distal end of the linkage group. This region corresponds to 2.2 Mbp (from 20.3 to 22.5 Mbp) on the physical map of 'Golden Delicious' containing nine candidate nucleotide-binding site leucine-rich repeat (NBS-LRR) resistance genes. This study increases our understanding of the complex genetic basis of apple scab resistance conferred by 'Geneva', as well as the gene-for-gene (GfG) relationships between the effector genes in the pathogen and resistance genes in the host.

  15. Underlying-event sensitive observables in Drell-Yan production using GENEVA

    NASA Astrophysics Data System (ADS)

    Alioli, Simone; Bauer, Christian W.; Guns, Sam; Tackmann, Frank J.

    2016-11-01

    We present an extension of the Geneva Monte Carlo framework to include multiple parton interactions (MPI) provided by Pythia8. This allows us to obtain predictions for underlying-event sensitive measurements in Drell-Yan production, in conjunction with Geneva 's fully differential NNLO calculation, NNLL' resummation for the 0-jet resolution variable (beam thrust), and NLL resummation for the 1-jet resolution variable. We describe the interface with the parton-shower algorithm and MPI model of Pythia8, which preserves both the precision of the partonic N-jet cross sections in Geneva as well as the shower accuracy and good description of soft hadronic physics of Pythia8. We present results for several underlying-event sensitive observables and compare to data from ATLAS and CMS as well as to standalone Pythia8 predictions. This includes a comparison with the recent ATLAS measurement of the beam thrust spectrum, which provides a potential avenue to fully disentangle the physical effects from the primary hard interaction, primary soft radiation, multiple parton interactions, and nonperturbative hadronization.

  16. Successful implementation and results of an HPV vaccination program in Geneva Canton, Switzerland.

    PubMed

    Jeannot, Emilien; Petignat, Patrick; Sudre, Philippe

    2015-01-01

    We describe a human papillomavirus (HPV) vaccination program implemented since 2007 in Geneva Canton, Switzerland, that used school services, a public hospital, and private physicians as vaccination providers. We assessed program performance with the evolution of immunization coverage during the first four years of program implementation. We measured vaccination coverage of the target population using individual records of vaccination status collected by service providers and transmitted to the Geneva Canton Medical Office. The target population was 20,541 adolescent girls aged 11-19 years as of September 1, 2008, who resided in the canton when the program began. As of June 30, 2012, HPV vaccination coverage was 72.6% and 74.8% in targeted cohorts for three and two doses, respectively. The global coverage for three doses increased by 27 percentage points from December 2009 to June 2012. Coverage for girls aged 16-18 years at the beginning of the program reached 80% or more four years into the program. High coverage by this HPV vaccination program in Geneva was likely related to free vaccination and easy access to the vaccine using a combination of delivery services, including school health services, a public hospital, and private physicians, covering most eligible adolescent girls.

  17. Dynamics of auto- and heterotrophic picoplankton and associated viruses in Lake Geneva

    NASA Astrophysics Data System (ADS)

    Parvathi, A.; Zhong, X.; Pradeep Ram, A. S.; Jacquet, S.

    2013-07-01

    Microbial dynamics has been rarely investigated in Lake Geneva, which is paradoxically the largest lake in Western Europe. From a 5 month survey, we report dynamic patterns of free living viruses, bacteria and small phytoplankton abundances in response to a variety of environmental parameters. For the first time, we fractionated the primary production to separate the contribution of different size-related biological compartments and measured both bacterial and viral production in addition to experiments conducted to appreciate virus-induced bacterial mortality. We observed marked seasonal and vertical variations in picocyanobacteria, bacteria and virus abundances and production. The contribution of picoplankton and nanoplankton production to the total primary production was high in November and spring-summer transition period respectively. The impact of viral lysis on both bacteria and picocyanobacteria was significantly higher than grazing activities. Virus-induced picocyanobacterial mortality reached up to 66% compared to virus induced bacterial mortality that reached a maximum of 34% in July. Statistical analyses revealed a complex interplay between biological abundances and/or activity with environmental factors in Lake Geneva. Our results provide new evidence on the critical role played by viruses in freshwater microbial dynamics and more globally on the functioning of the microbial food webs. This study highlights the importance of further considering this biological compartment for a better understanding of the plankton ecology of Lake Geneva, especially for modeling purposes and in a context of reoligotrophication and warming of this ecosystem.

  18. MonDossierMedical.ch - The Personal Health Record for Every Geneva Citizen.

    PubMed

    Rosemberg, Aurélie; Schmid, Adian; Plaut, Olivier

    2016-01-01

    MonDossierMedical.ch is a project led by the canton of Geneva, making it possible for every patient to access his own electronic health record (EHR) and to share the medical files with his doctors. It was introduced across the canton in mid-2013, and provided to all patients free of charge. It is based on the first Swiss-wide eHealth-compliant pilot project "e-toile". The canton of Geneva developed "e-toile" as a public-private partnership together with Swiss Post and it was launched in 2011 in some of the canton's municipalities. Back then, Geneva's EHR represented the first Swiss attempt to link all healthcare professionals in the treatment chain. Today, it serves more than 6,000 patients and 400 physicians. This number is growing regularly, as well as the health care institutions (private hospitals, labs) joining the community. The project fits into the national strategy of Switzerland in establishing a national EHR by linking regional implementations like MonDossierMedical.

  19. Interacting forms of expertise in security governance: the example of CCTV surveillance at Geneva International Airport.

    PubMed

    Klauser, Francisco

    2009-06-01

    The paper investigates the multiple public-private exchanges and cooperation involved in the installation and development of CCTV surveillance at Geneva International Airport. Emphasis is placed on the interacting forms of authority and expertise of five parties: the user(s), owner and supplier of the camera system, as well as the technical managers of the airport and the Swiss regulatory bodies in airport security. While placing the issues of airport surveillance in the particular context of a specific range of projects and transformations relating to the developments of CCTV at Geneva Airport, the paper not only provides important insights into the micro-politics of surveillance at Geneva Airport, but aims to re-institute these as part of a broader 'problematic': the mediating role of expertise and the growing functional fragmentation of authority in contemporary security governance. On this basis, the paper also exemplifies the growing mutual interdependences between security and business interests in the ever growing 'surveillant assemblage' in contemporary security governance.

  20. Combination therapy in hypertension: an Asia-Pacific consensus viewpoint.

    PubMed

    Abdul Rahman, Abdul Rashid; Reyes, Eugenio B; Sritara, Piyamitr; Pancholia, Arvind; Van Phuoc, Dang; Tomlinson, Brian

    2015-05-01

    Hypertension incurs a significant healthcare burden in Asia-Pacific countries, which have suboptimal rates of blood pressure (BP) treatment and control. A consensus meeting of hypertension experts from the Asia-Pacific region convened in Hanoi, Vietnam, in April 2013. The principal objectives were to discuss the growing problem of hypertension in the Asia-Pacific region, and to develop consensus recommendations to promote standards of care across the region. A particular focus was recommendations for combination therapy, since it is known that most patients with hypertension will require two or more antihypertensive drugs to achieve BP control, and also that combinations of drugs with complementary mechanisms of action achieve BP targets more effectively than monotherapy. The expert panel reviewed guidelines for hypertension management from the USA and Europe, as well as individual Asia-Pacific countries, and devised a treatment matrix/guide, in which they propose the preferred combination therapy regimens for patients with hypertension, both with and without compelling indications. This report summarizes key recommendations from the group, including recommended antihypertensive combinations for specific patient populations. These strategies generally entail initiating therapy with free drug combinations, starting with the lowest available dosage, followed by treatment with single-pill combinations once the BP target has been achieved. A single reference for the whole Asia-Pacific region may contribute to increased consistency of treatment and greater proportions of patients achieving BP control, and hence reducing hypertension-related morbidity and mortality.

  1. [The latest in paediatric resuscitation recommendations].

    PubMed

    López-Herce, Jesús; Rodríguez, Antonio; Carrillo, Angel; de Lucas, Nieves; Calvo, Custodio; Civantos, Eva; Suárez, Eva; Pons, Sara; Manrique, Ignacio

    2017-04-01

    Cardiac arrest has a high mortality in children. To improve the performance of cardiopulmonary resuscitation, it is essential to disseminate the international recommendations and the training of health professionals and the general population in resuscitation. This article summarises the 2015 European Paediatric Cardiopulmonary Resuscitation recommendations, which are based on a review of the advances in cardiopulmonary resuscitation and consensus in the science and treatment by the International Council on Resuscitation. The Spanish Paediatric Cardiopulmonary Resuscitation recommendations, developed by the Spanish Group of Paediatric and Neonatal Resuscitation, are an adaptation of the European recommendations, and will be used for training health professionals and the general population in resuscitation. This article highlights the main changes from the previous 2010 recommendations on prevention of cardiac arrest, the diagnosis of cardiac arrest, basic life support, advanced life support and post-resuscitation care, as well as reviewing the algorithms of treatment of basic life support, obstruction of the airway and advanced life support.

  2. C1 inhibitor deficiency: 2014 United Kingdom consensus document.

    PubMed

    Longhurst, H J; Tarzi, M D; Ashworth, F; Bethune, C; Cale, C; Dempster, J; Gompels, M; Jolles, S; Seneviratne, S; Symons, C; Price, A; Edgar, D

    2015-06-01

    C1 inhibitor deficiency is a rare disorder manifesting with recurrent attacks of disabling and potentially life-threatening angioedema. Here we present an updated 2014 United Kingdom consensus document for the management of C1 inhibitor-deficient patients, representing a joint venture between the United Kingdom Primary Immunodeficiency Network and Hereditary Angioedema UK. To develop the consensus, we assembled a multi-disciplinary steering group of clinicians, nurses and a patient representative. This steering group first met in 2012, developing a total of 48 recommendations across 11 themes. The statements were distributed to relevant clinicians and a representative group of patients to be scored for agreement on a Likert scale. All 48 statements achieved a high degree of consensus, indicating strong alignment of opinion. The recommendations have evolved significantly since the 2005 document, with particularly notable developments including an improved evidence base to guide dosing and indications for acute treatment, greater emphasis on home therapy for acute attacks and a strong focus on service organization.

  3. C1 inhibitor deficiency: 2014 United Kingdom consensus document

    PubMed Central

    Longhurst, H J; Tarzi, M D; Ashworth, F; Bethune, C; Cale, C; Dempster, J; Gompels, M; Jolles, S; Seneviratne, S; Symons, C; Price, A; Edgar, D

    2015-01-01

    C1 inhibitor deficiency is a rare disorder manifesting with recurrent attacks of disabling and potentially life-threatening angioedema. Here we present an updated 2014 United Kingdom consensus document for the management of C1 inhibitor-deficient patients, representing a joint venture between the United Kingdom Primary Immunodeficiency Network and Hereditary Angioedema UK. To develop the consensus, we assembled a multi-disciplinary steering group of clinicians, nurses and a patient representative. This steering group first met in 2012, developing a total of 48 recommendations across 11 themes. The statements were distributed to relevant clinicians and a representative group of patients to be scored for agreement on a Likert scale. All 48 statements achieved a high degree of consensus, indicating strong alignment of opinion. The recommendations have evolved significantly since the 2005 document, with particularly notable developments including an improved evidence base to guide dosing and indications for acute treatment, greater emphasis on home therapy for acute attacks and a strong focus on service organization. PMID:25605519

  4. Per oral cholangiopancreatoscopy in pancreatico biliary diseases - Expert consensus statements

    PubMed Central

    Ramchandani, Mohan; Reddy, Duvvur Nageshwar; Lakhtakia, Sundeep; Tandan, Manu; Maydeo, Amit; Chandrashekhar, Thoguluva Seshadri; Kumar, Ajay; Sud, Randhir; Rerknimitr, Rungsun; Makmun, Dadang; Khor, Christopher

    2015-01-01

    AIM: To provide consensus statements on the use of per-oral cholangiopancreatoscopy (POCPS). METHODS: A workgroup of experts in endoscopic retrograde cholangiopancreatography (ERCP), endosonography, and POCPS generated consensus statements summarizing the utility of POCPS in pancreaticobiliary disease. Recommendation grades used validated evidence ratings of publications from an extensive literature review. RESULTS: Six consensus statements were generated: (1) POCPS is now an important additional tool during ERCP; (2) in patients with indeterminate biliary strictures, POCS and POCS-guided targeted biopsy are useful for establishing a definitive diagnosis; (3) POCS and POCS-guided lithotripsy are recommended for treatment of difficult common bile duct stones when standard techniques fail; (4) in patients with main duct intraductal papillary mucinous neoplasms (IPMN) POPS may be used to assess extent of tumor to assist surgical resection; (5) in difficult pancreatic ductal stones, POPS-guided lithotripsy may be useful in fragmentation and extraction of stones; and (6) additional indications for POCPS include selective guidewire placement, unexplained hemobilia, assessing intraductal biliary ablation therapy, and extracting migrated stents. CONCLUSION: POCPS is important in association with ERCP, particularly for diagnosis of indeterminate biliary strictures and for intra-ductal lithotripsy when other techniques failed, and may be useful for pre-operative assessment of extent of main duct IPMN, for extraction of difficult pancreatic stones, and for unusual indications involving selective guidewire placement, assessing unexplained hemobilia or intraductal biliary ablation therapy, and extracting migrated stents. PMID:25914484

  5. Cardiovascular–renal axis disorders in the domestic dog and cat: a veterinary consensus statement

    PubMed Central

    Pouchelon, J L; Atkins, C E; Bussadori, C; Oyama, M A; Vaden, S L; Bonagura, J D; Chetboul, V; Cowgill, L D; Elliot, J; Francey, T; Grauer, G F; Luis Fuentes, V; Sydney Moise, N; Polzin, D J; Van Dongen, A M; Van Israël, N

    2015-01-01

    OBJECTIVES There is a growing understanding of the complexity of interplay between renal and cardiovascular systems in both health and disease. The medical profession has adopted the term “cardiorenal syndrome” (CRS) to describe the pathophysiological relationship between the kidney and heart in disease. CRS has yet to be formally defined and described by the veterinary profession and its existence and importance in dogs and cats warrant investigation. The CRS Consensus Group, comprising nine veterinary cardiologists and seven nephrologists from Europe and North America, sought to achieve consensus around the definition, pathophysiology, diagnosis and management of dogs and cats with “cardiovascular-renal disorders” (CvRD). To this end, the Delphi formal methodology for defining/building consensus and defining guidelines was utilised. METHODS Following a literature review, 13 candidate statements regarding CvRD in dogs and cats were tested for consensus, using a modified Delphi method. As a new area of interest, well-designed studies, specific to CRS/CvRD, are lacking, particularly in dogs and cats. Hence, while scientific justification of all the recommendations was sought and used when available, recommendations were largely reliant on theory, expert opinion, small clinical studies and extrapolation from data derived from other species. RESULTS Of the 13 statements, 11 achieved consensus and 2 did not. The modified Delphi approach worked well to achieve consensus in an objective manner and to develop initial guidelines for CvRD. DISCUSSION The resultant manuscript describes consensus statements for the definition, classification, diagnosis and management strategies for veterinary patients with CvRD, with an emphasis on the pathological interplay between the two organ systems. By formulating consensus statements regarding CvRD in veterinary medicine, the authors hope to stimulate interest in and advancement of the understanding and management of CvRD in

  6. [Neuroendocrine dysfunction and brain damage. A consensus statement].

    PubMed

    Leal-Cerro, Alfonso; Rincón, María Dolores; Domingo, Manel Puig

    2009-01-01

    This consensus statement aims to enhance awareness of the incidence and risks of hypopituitarism in patients with traumatic brain injury (TBI) and/or brain hemorrhages among physicians treating patients with brain damage. The importance of this problem is related not only to the frequency of TBI but also to its prevalence in younger populations. The consequences of TBI are characterized by a series of symptoms that depend on the type of sequels related to neuroendocrine dysfunction. The signs and symptoms of hypopituitarism are often confused with those of other sequels of TBI. Consequently, patients with posttraumatic hypopituitarism may receive suboptimal rehabilitation unless the underlying hormone deficiency is identified and treated. This consensus is based on the recommendation supported by expert opinion that patients with a TBI and/or brain hemorrhage should undergo endocrine evaluation in order to assess pituitary function and, if deficiency is detected, should receive hormone replacement therapy.

  7. Expert Consensus for Discharge Referral Decisions Using Online Delphi

    PubMed Central

    Bowles, Kathy H.; Holmes, John H.; Naylor, Mary D.; Liberatore, Matthew; Nydick, Robert

    2003-01-01

    This paper describes the results of using a modified Delphi approach designed to achieve consensus from eight discharge planning experts regarding the decision to refer hospitalized older adults for post-discharge follow-up. Experts reviewed 150 cases using an online website designed to facilitate their interaction and efforts to reach agreement on the need for a referral for post-discharge care and the appropriate site for such care. In contrast to an average of eight weeks to complete just 50 cases using the traditional mail method, the first online Delphi round for 150 cases were completed in six weeks. Data provided by experts suggest that online Delphi is a time efficient and acceptable methodology for reaching group consensus. Other benefits include instant access to Delphi decision results, live knowledge of the time requirements and progress of each expert, and cost savings in postage, paper, copying, and storage of paper documents. This online Delphi methodology is highly recommended. PMID:14728143

  8. In control? IQC consensus and statutory regulation.

    PubMed

    Lee, Graham R; Fitzgibbon, Maria C; O'Shea, Paula

    2016-06-13

    Purpose - Internal quality control (IQC) represents an essential risk management tool within the total testing pathway (TTP) that contributes to the overall objective of assuring the quality of results produced in medical laboratories. Controlling analytical phase quality alone requires significant expertise and input by scientifically trained staff. This effort has escalated exponentially following the publication of the International Organisation for Standardisation (ISO)15189:2012 requirements for quality and competence in medical laboratories. The reported inconsistency and diversity to IQC approaches in diagnostic laboratories is definitive evidence that international guidance in IQC programme design and implementation is long overdue. The paper aims to discuss these issues. Design/methodology/approach - Herein, the authors define, describe and critically examine the essential elements four stages of an IQC programme and suggest a template to inform both design and ease of implementation. For practical application, the authors have stratified the proposed methodology into four stages: staff education and training; IQC material; IQC targets; and IQC procedure, and provide recommendations that meet ISO15189:2012 requirements. Findings - These recommendations are informed by the published literature together with the collective experience working in clinical biochemistry and diagnostic endocrinology laboratories. The authors note that the laboratory staff's effort on IQC is a continuous process, driven by changes within each IQC stage, in response to risk analysis, maximising economic value or through professional leadership and central to IQC programme implementation and delivery. Practical implications - The authors offer a template that laboratories can use to inform the design and implementation of their IQC programme. Originality/value - The proposed IQC programme is user friendly, flexible and pragmatic with the potential to harmonise practice. The authors

  9. Consensus Conference on North American Training in Hepatopancreaticobiliary Surgery: A Review of the Conference and Presentation of Consensus Statements.

    PubMed

    Jeyarajah, D Rohan; Berman, Russell S; Doyle, Majella; Geevarghese, Sunil K; Posner, Mitchell C; Farmer, Douglas; Minter, Rebecca M

    2016-07-01

    The findings and recommendations of the North American Consensus Conference on Training in HPB Surgery held October 2014 are presented. The conference was hosted by the Society for Surgical Oncology (SSO), Americas Hepatopancreaticobiliary Association (AHPBA), and the American Society of Transplant Surgeons (ASTS). The current state of training in HPB surgery in North America was defined through three pathways-HPB, Surgical Oncology, and Solid Organ Transplant fellowships. Consensus regarding programmatic requirements included establishment of minimum case volumes and inclusion of quality metrics. Formative assessment, using milestones as a framework and inclusive of both operative and non-operative skills, must be present. Specific core HPB cases should be defined and used for evaluation of operative skills. The conference concluded with a focus on the optimal means to perform summative assessment to evaluate the individual fellow completing a fellowship in HPB surgery. Presentations from the hospital perspective and the American Board of Surgery led to consensus that summative assessment was desired by the public and the hospital systems, and should occur in a uniform but possibly modular manner for all HPB fellowship pathways. A task force comprised of representatives of the SSO, AHPBA, and ASTS are charged with implementation of the consensus statements emanating from this consensus conference.Copyright © 2016 The American Society of Transplantation, the American Society of Transplant Surgeons, and the Society of Surgical Oncology. All rights reserved. No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission by The American Society of Transplantation, the American Society of Transplant Surgeons, or the Society of Surgical Oncology.

  10. Consensus Statement on Standard of Care for Congenital Myopathies

    PubMed Central

    Wang, Ching H.; Dowling, James J.; North, Kathryn; Schroth, Mary K.; Sejersen, Thomas; Shapiro, Frederic; Bellini, Jonathan; Weiss, Hali; Guillet, Marc; Amburgey, Kimberly; Apkon, Susan; Bertini, Enrico; Bonnemann, Carsten; Clarke, Nigel; Connolly, Anne M.; Estournet-Mathiaud, Brigitte; Fitzgerald, Dominic; Florence, Julaine M.; Gee, Richard; Gurgel-Giannetti, Juliana; Glanzman, Allan M.; Hofmeister, Brittany; Jungbluth, Heinz; Koumbourlis, Anastassios C.; Laing, Nigel G.; Main, Marion; Morrison, Leslie A.; Munns, Craig; Rose, Kristy; Schuler, Pamela M.; Sewry, Caroline; Storhaug, Kari; Vainzof, Mariz; Yuan, Nanci

    2016-01-01

    Recent progress in scientific research has facilitated accurate genetic and neuropathological diagnosis of congenital myopathies. However, given their relatively low incidence, congenital myopathies remain unfamiliar to the majority of care providers, and the levels of patient care are extremely variable. This consensus statement aims to provide care guidelines for congenital myopathies. The International Standard of Care Committee for Congenital Myopathies worked through frequent e-mail correspondences, periodic conference calls, 2 rounds of online surveys, and a 3-day workshop to achieve a consensus for diagnostic and clinical care recommendations. The committee includes 59 members from 10 medical disciplines. They are organized into 5 working groups: genetics/diagnosis, neurology, pulmonology, gastroenterology/nutrition/speech/oral care, and orthopedics/rehabilitation. In each care area the authors summarize the committee’s recommendations for symptom assessments and therapeutic interventions. It is the committee’s goal that through these recommendations, patients with congenital myopathies will receive optimal care and improve their disease outcome. PMID:22431881

  11. Consensus formation on adaptive networks

    NASA Astrophysics Data System (ADS)

    Kozma, Balazs; Barrat, Alain

    2008-01-01

    The structure of a network can significantly influence the properties of the dynamical processes that take place on them. While many studies have been paid to this influence, much less attention has been devoted to the interplay and feedback mechanisms between dynamical processes and network topology on adaptive networks. Adaptive rewiring of links can happen in real life systems such as acquaintance networks, where people are more likely to maintain a social connection if their views and values are similar. In our study, we consider different variants of a model for consensus formation. Our investigations reveal that the adaptation of the network topology fosters cluster formation by enhancing communication between agents of similar opinion, although it also promotes the division of these clusters. The temporal behavior is also strongly affected by adaptivity: while, on static networks, it is influenced by percolation properties, on adaptive networks, both the early and late time evolutions of the system are determined by the rewiring process. The investigation of a variant of the model reveals that the scenarios of transitions between consensus and polarized states are more robust on adaptive networks.

  12. [Inter-hospital CHUV-HUG medical consensus of back pain management. Its application in care pathways within CHUV of Lausanne].

    PubMed

    de Goumoens, Pierre; Genevay, Stéphane; Tessitore, Enrico; Zaarour, Maroun; Duff, John Michael; Faundez, Antonio; Schizas, Constantin; Schindler, Maximilian; Zoccatelli, Davide; Foletti, Antonio; Norberg, Iohn; Belgrand, Liliana; Griesser, Anne-Claude; Kulik, Gerit

    2014-04-30

    Back pain is a considerable economical burden in industrialised countries. Its management varies widely across countries, including Switzerland. Thus, the University Hospital and University of Lausanne (CHUV) recently improved intern processes of back pain care. In an already existing collaborative context, the two university hospitals in French-speaking Switzerland (CHUV, University Hospital of Geneva), felt the need of a medical consensus, based on a common concept. This inter-hospital consensus produced three decisional algorithms that bear on recent concepts of back pain found in literature. Eventually, a fast track was created at CHUV, to which extern physicians will have an organised and rapid access. This fast track aims to reduce chronic back pain conditions and provides specialised education for general practitioners-in-training.

  13. "Just as the Structural Formula Does": Names, Diagrams, and the Structure of Organic Chemistry at the 1892 Geneva Nomenclature Congress.

    PubMed

    Hepler-Smith, Evan

    2015-02-01

    At the Geneva Nomenclature Congress of 1892, some of the foremost organic chemists of the late nineteenth century crafted a novel relationship between chemical substances, chemical diagrams, and chemical names that has shaped practices of chemical representation ever since. During the 1880s, the French chemist Charles Friedel organised the nomenclature reform effort that culminated in the Geneva Congress; in the disorderly nomenclature of German synthetic chemistry, Friedel saw an opportunity to advance French national interests and his own pedagogical goals. Friedel and a group of close colleagues reconceived nomenclature as a unified field, in which all chemical names ought to relate clearly to one another and to the structure of the compounds they represented. The German chemist Adolf von Baeyer went a step farther, arguing for names that precisely and uniquely corresponded to the structural formula of each compound, tailored for use in chemical dictionaries and handbooks. Baeyer's vision prevailed at the Geneva Congress, which consequently codified rules for rigorously mapping structural formulas into names, resulting in names that faithfully represented the features of these diagrams but not always the chemical behaviour of the compounds themselves. This approach ultimately limited both the number of chemical compounds that the Geneva rules were able to encompass and the breadth of their application. However, the relationship between diagram and name established at the Geneva Congress became the foundation not only of subsequent systems of chemical nomenclature but of methods of organising information that have supported the modern chemical sciences.

  14. National consensus in China on diagnosis and treatment of patients with advanced breast cancer

    PubMed Central

    Hu, Xichun; Jiang, Zefei; Li, Huiping; Chen, Jiayi; Cui, Shude; Li, Qing; Liao, Ning; Liu, Donggeng; Liu, Jian; Lu, Jinsong; Shen, Kunwei; Sun, Tao; Teng, Yuee; Tong, Zhongsheng; Wang, Shulian; Wang, Xiang; Wang, Xiaojia; Wang, Yongsheng; Wu, Jiong; Yuan, Peng; Zhang, Pin; Zhang, Qingyuan; Zheng, Hong; Pang, Da; Ren, Guosheng; Shao, Zhimin; Shen, Zhenzhou; Song, Erwei; Song, Santai

    2015-01-01

    The recently available guidelines on the management of advanced breast cancer (ABC) organized by Chinese Anti-Cancer Association, Committee of Breast Cancer Society (CACA-CBCS) do not elucidate ABC in details. To instruct clinicians in treatment of ABC, a Chinese expert consensus meeting on diagnosis and treatment of ABC was held in June 2014 and a consensus is developed. The following consensus provides the level of evidence and supporting documents for each recommendation, and introduces research topics to be urgently addressed. Notably, the consensus on diagnosis and treatment of ABC in China is developed to be applied nationwide. In different areas, multidisciplinary treatment (MDT) tailored to the each patient and the disease itself should be applied based on the basic principles of modern oncology. PMID:26605288

  15. CSS Council Task Force on Reauthorization: Recommendations for Improving Federal Aid Delivery. Research Report.

    ERIC Educational Resources Information Center

    College Entrance Examination Board, New York, NY.

    The College Scholarship Service (CSS) Council Task Force on Reauthorization presented its recommendations to the CSS Council in December 2002. The Task Force focused its recommendations on issues that address the overarching goal of ensuring access to higher education for the most needy students. The recommendations reflect the consensus of CSS…

  16. Changing pattern of age-specific breast cancer incidence in the Swiss canton of Geneva.

    PubMed

    Bouchardy, Christine; Usel, Massimo; Verkooijen, Helena M; Fioretta, Gérald; Benhamou, Simone; Neyroud-Caspar, Isabelle; Schaffar, Robin; Vlastos, Georges; Wespi, Yves; Schäfer, Peter; Rapiti, Elisabetta

    2010-04-01

    Hormone replacement therapy (HRT) use declined sharply after mid-2002, when the Women's Health Initiative trial reported an association between breast cancer occurrence and HRT. Hypothesized mechanism behind this association is that HRT promotes growth of pre-existing small tumors, leading to earlier tumor detection. We evaluated the impact of the sudden decline in HRT use on age distribution of breast cancer in Geneva. We included all incident breast cancer cases recorded from 1975 to 2006 at the Geneva cancer registry. We calculated mean annual incidence rates per 100,000 for 2 year periods for three age groups and assessed temporal changes by joinpoint regression. We compared age-specific incidence curves for different periods, reflecting different prevalence rates of HRT use. After increasing constantly between 1986 and 2002 among women aged 50-69 years [annual percent change (APC): +4.4, P < 0.0001], rates declined sharply after 2003 (APC: -6.0; P = 0.0264). Age-specific breast cancer rates changed dramatically with changes in prevalence of HRT use. During low HRT prevalence, breast cancer incidence increased progressively with age, when HRT prevalence was reaching its maximum (1995-2002), higher rates were seen in 60- to 64-year-old women, with a concomitant decrease in risk among elderly. After the sudden decline in HRT use, the incidence peak diminished significantly and incidence increased again with age. Following the abrupt decline in HRT use in Geneva, breast cancer incidence rates among post-menopausal women decreased considerably with striking changes in age-specific incidence rates before, during and after the peak in HRT prevalence.

  17. A catastrophic event in Lake Geneva region during the Early Bronze Age?

    NASA Astrophysics Data System (ADS)

    Kremer, Katrina; Yrro, Blé; Marillier, François; Hilbe, Michael; Corboud, Pierre; Rachoud-Schneider, Anne-Marie; Girardclos, Stéphanie

    2013-04-01

    Similarly to steep oceanic continental margins, lake slopes can collapse, producing large sublacustrine landslides and tsunamis. Lake sediments are excellent natural archives of such mass movements and their study allows the reconstructions of these prehistoric events, such as the 563 AD large tsunami over Lake Geneva (Kremer et al, 2012). In Lake Geneva, more than 100 km of high-resolution seismic reflection profiles reveal the late Holocene sedimentation history. The seismic record shows a succession of five large lens-shaped seismic units (A to I), characterized by transparent/chaotic seismic facies with irregular lower boundaries, and interpreted as mass-movement deposits. These units are interbedded with parallel, continuous and strong amplitude reflections, interpreted as the 'background' lake sediments. The oldest dated mass movement (Unit D) covers a surface of 22 km2 in the deep basin, near the city of Lausanne. This deposit has an estimated minimum volume of 0.18 km3 and thus was very likely tsunamigenic (Kremer et al, 2012). A 12-m-long sediment core confirms the seismic interpretation of the mass movement unit and shows that the uppermost 3 m of Unit D are characterized by deformed hemipelagic sediments topped by a 5 cm thick turbidite. This deposit can be classified as a slump whose scar can be interpreted in the seismic data and visualized by multibeam bathymetry. This slump of Lausanne was likely triggered by an earthquake but a spontaneous slope collapse cannot be excluded (Girardclos et al, 2007). Radiocarbon dating of plant macro-remains reveals that the unit D happened during Early Bronze Age. Three other mass wasting deposits occurred during the same time period and may have been triggered during the same event, either by a single earthquake or by a tsunami generated by the slump of Lausanne. Although the exact trigger mechanism of the all these mass-wasting deposits remains unknown, a tsunami likely generated by this event may have affected the

  18. The stellar and solar tracking system of the Geneva Observatory gondola

    NASA Technical Reports Server (NTRS)

    Huguenin, D.

    1974-01-01

    Sun and star trackers have been added to the latest version of the Geneva Observatory gondola. They perform an image motion compensation with an accuracy of plus or minus 1 minute of arc. The structure is held in the vertical position by gravity; the azimuth is controlled by a torque motor in the suspension bearing using solar or geomagnetic references. The image motion compensation is performed by a flat mirror, located in front of the telescope, controlled by pitch and yaw servo-loops. Offset pointing is possible within the solar disc and in a 3 degree by 3 degree stellar field. A T.V. camera facilitates the star identification and acquisition.

  19. [Mental health and psychiatry: role and issues of the Geneva mental health associations' network].

    PubMed

    León, C; Benitez, C; Dupanloup, A; Saloukvadze, G; Zinder, A; de Marsano-Ernoult, G; Krummenacher, T

    2009-09-16

    The psychosocial Geneva-based associations provide ongoing support to people suffering from mental disorders and their families. This network gives psychological care and works towards social inclusion. This approach is an alternative as well as a complement to medical care. The services offered by the associations are varied: mutual self-help, providing a place to live and a space dedicated to specific activities, family support, counselling, therapy, etc. They have two central issues: improving quality of life and promoting the rights of patients. Collaboratively, they are in constant dialogue with the psychiatric institutions in the canton, leading to joint activities and furthering the thinking on patient health and rehabilitation.

  20. Consensus of Hybrid Multi-Agent Systems.

    PubMed

    Zheng, Yuanshi; Ma, Jingying; Wang, Long

    2017-01-27

    In this brief, we consider the consensus problem of hybrid multiagent systems. First, the hybrid multiagent system is proposed, which is composed of continuous-time and discrete-time dynamic agents. Then, three kinds of consensus protocols are presented for the hybrid multiagent system. The analysis tool developed in this brief is based on the matrix theory and graph theory. With different restrictions of the sampling period, some necessary and sufficient conditions are established for solving the consensus of the hybrid multiagent system. The consensus states are also obtained under different protocols. Finally, simulation examples are provided to demonstrate the effectiveness of our theoretical results.

  1. Consensus in Guidelines for Evaluation of DSD by the Texas Children's Hospital Multidisciplinary Gender Medicine Team.

    PubMed

    Douglas, Ganka; Axelrad, Marni E; Brandt, Mary L; Crabtree, Elizabeth; Dietrich, Jennifer E; French, Shannon; Gunn, Sheila; Karaviti, Lefkothea; Lopez, Monica E; Macias, Charles G; McCullough, Laurence B; Suresh, Deepa; Sutton, V Reid

    2010-01-01

    The Gender Medicine Team (GMT), comprised of members with expertise in endocrinology, ethics, genetics, gynecology, pediatric surgery, psychology, and urology, at Texas Children's Hospital and Baylor College of Medicine formed a task force to formulate a consensus statement on practice guidelines for managing disorders of sexual differentiation (DSD) and for making sex assignments. The GMT task force reviewed published evidence and incorporated findings from clinical experience. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to assess the quality of evidence presented in the literature for establishing evidence-based guidelines. The task force presents a consensus statement regarding specific diagnostic and therapeutic issues in the management of individuals who present with DSD. The consensus statement includes recommendations for (1) laboratory workup, (2) acute management, (3) sex assignment in an ethical framework that includes education and involvement of the parents, and (4) surgical management.

  2. Learning consensus in adversarial environments

    NASA Astrophysics Data System (ADS)

    Vamvoudakis, Kyriakos G.; García Carrillo, Luis R.; Hespanha, João. P.

    2013-05-01

    This work presents a game theory-based consensus problem for leaderless multi-agent systems in the presence of adversarial inputs that are introducing disturbance to the dynamics. Given the presence of enemy components and the possibility of malicious cyber attacks compromising the security of networked teams, a position agreement must be reached by the networked mobile team based on environmental changes. The problem is addressed under a distributed decision making framework that is robust to possible cyber attacks, which has an advantage over centralized decision making in the sense that a decision maker is not required to access information from all the other decision makers. The proposed framework derives three tuning laws for every agent; one associated with the cost, one associated with the controller, and one with the adversarial input.

  3. Assessing and managing multiple risks in a changing world – the Roskilde recommendations.

    EPA Science Inventory

    Roskilde University (Denmark) hosted a November 2015 workshop, Environmental Risk—Assessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common curre...

  4. Optimal blood pressure targets in 2014 - Does the guideline recommendation match the evidence base?

    PubMed

    Alviar, C L; Bangalore, S; Messerli, F H

    2015-01-01

    Various scientific societies have recently published practice guidelines for the diagnosis and management of arterial hypertension with no clear consensus on a blood pressure target. This article reviews those recommendations and critically examines if they are based on sound evidence.

  5. Assessing and Managing Multiple Risks in a Changing World – the Roskilde Recommendations

    EPA Science Inventory

    Roskilde University hosted a November 2015 workshop on “Environmental Risk – Assessing and Managing Multiple Risks in a Changing World”. Thirty attendees from 9 countries developed consensus recommendations regarding: implementation of a common currency (ecosyst...

  6. International Consensus on drug allergy.

    PubMed

    Demoly, P; Adkinson, N F; Brockow, K; Castells, M; Chiriac, A M; Greenberger, P A; Khan, D A; Lang, D M; Park, H-S; Pichler, W; Sanchez-Borges, M; Shiohara, T; Thong, B Y- H

    2014-04-01

    When drug reactions resembling allergy occur, they are called drug hypersensitivity reactions (DHRs) before showing the evidence of either drug-specific antibodies or T cells. DHRs may be allergic or nonallergic in nature, with drug allergies being immunologically mediated DHRs. These reactions are typically unpredictable. They can be life-threatening, may require or prolong hospitalization, and may necessitate changes in subsequent therapy. Both underdiagnosis (due to under-reporting) and overdiagnosis (due to an overuse of the term ‘allergy’) are common. A definitive diagnosis of such reactions is required in order to institute adequate treatment options and proper preventive measures. Misclassification based solely on the DHR history without further testing may affect treatment options, result in adverse consequences, and lead to the use of more-expensive or less-effective drugs, in contrast to patients who had undergone a complete drug allergy workup. Several guidelines and/or consensus documents on general or specific drug class-induced DHRs are available to support the medical decision process. The use of standardized systematic approaches for the diagnosis and management of DHRs carries the potential to improve outcomes and should thus be disseminated and implemented. Consequently, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), formed by the European Academy of Allergy and Clinical Immunology (EAACI), the American Academy of Allergy, Asthma and Immunology (AAAAI), the American College of Allergy, Asthma and Immunology (ACAAI), and the World Allergy Organization (WAO), has decided to issue an International CONsensus (ICON) on drug allergy. The purpose of this document is to highlight the key messages that are common to many of the existing guidelines, while critically reviewing and commenting on any differences and deficiencies of evidence, thus providing a comprehensive reference document for the diagnosis and management of

  7. Data publication consensus and controversies

    PubMed Central

    Kratz, John; Strasser, Carly

    2014-01-01

    The movement to bring datasets into the scholarly record as first class research products (validated, preserved, cited, and credited) has been inching forward for some time, but now the pace is quickening. As data publication venues proliferate, significant debate continues over formats, processes, and terminology. Here, we present an overview of data publication initiatives underway and the current conversation, highlighting points of consensus and issues still in contention. Data publication implementations differ in a variety of factors, including the kind of documentation, the location of the documentation relative to the data, and how the data is validated. Publishers may present data as supplemental material to a journal article, with a descriptive “data paper,” or independently. Complicating the situation, different initiatives and communities use the same terms to refer to distinct but overlapping concepts. For instance, the term published means that the data is publicly available and citable to virtually everyone, but it may or may not imply that the data has been peer-reviewed. In turn, what is meant by data peer review is far from defined; standards and processes encompass the full range employed in reviewing the literature, plus some novel variations. Basic data citation is a point of consensus, but the general agreement on the core elements of a dataset citation frays if the data is dynamic or part of a larger set. Even as data publication is being defined, some are looking past publication to other metaphors, notably “data as software,” for solutions to the more stubborn problems. PMID:25075301

  8. Designing a Biocontainment Unit to Care for Patients with Serious Communicable Diseases: A Consensus Statement

    DTIC Science & Technology

    2006-08-29

    disinfection, personal protective equipment); facility design, structure, and construction fea- tures; and psychosocial and ethical issues , are summarized...features; and psychosocial and ethical issues , are summarized and addressed in detail in an appendix. The consensus recommendations are presented to...and Ethical Issues A. Patient psychosocial issues B. Staff psychosocial issues C. Ethical issues tainment laboratories and index cases of potentially

  9. Building a Consensus on Community Health Workers’ Scope of Practice: Lessons From New York

    PubMed Central

    Matos, Sergio; Hicks, April L.; Campbell, Ayanna; Moore, Addison; Diaz, Diurka

    2012-01-01

    Objectives. We evaluated efforts in New York to build a consensus between community health workers (CHWs) and employers on CHWs’ scope of practice, training standards, and certification procedures. Methods. We conducted multiple-choice surveys in 2008 and 2010 with 226 CHWs and 44 employers. We compared CHWs’ and employers’ recommendations regarding 28 scope of practice elements. The participatory ranking method was used to identify consensus scope of practice recommendations. Results. There was consensus on 5 scope of practice elements: outreach and community organizing, case management and care coordination, home visits, health education and coaching, and system navigation. For each element, 3 to 4 essential skills were identified, giving a total of 27 skills. These included all skills recommended in national CHW studies, along with 3 unique to New York: computer skills, participatory research methods, and time management. Conclusions. CHWs and employers in New York were in consensus on CHWs’ scope of practice on virtually all of the detailed core competency skills. The CHW scope of practice recommendations of these groups can help other states refine their scope of practice elements. PMID:22897548

  10. [Reproductive health among migrant women in Geneva: what are the challenges for Community-based participatory research].

    PubMed

    Schmidt N C; Fargnoli V

    2014-10-22

    Community-based participatory research (CBPR) focuses on inequalities in health by involving community members and researchers in all parts of the research process. The project COMIRES (COmmunity Migrant RESearch), based in the Department of Obstetrics and Gynecology at the University Hospitals of Geneva, engages academic researchers and migrant communities in Geneva in a co-learning process to understand barriers to reproductive health services and evaluate the role of the community. The article illustrates the methodological approach, but also advantages and challenges of CBPR.

  11. [The diagnostic contributions and pharmaceutic prescriptions of the Geneva physician Théodore Tronchin in 1763].

    PubMed

    Silberman, Henri C

    2004-01-01

    The Geneva physician Théodore Tronchin (1709-1801) was one of the best known physicians in Europe. Some copies of his letters giving medical advice to his patients all over the world are preserved in the University Library of Geneva. One of them dated 1763 was chosen as an example of Tronchin's dealings with his patients. In it Tronchin gives his opinion about the venereal disease transmitted to princess Marie-Thérèse of Hohenzollern-Hechingen (1732-1802) by her husband. Tronchin prescribed treatment based on mercury and sudorific plants.

  12. Amnesia in frontotemporal dementia: shedding light on the Geneva historical data.

    PubMed

    Papageorgiou, Sokratis G; Beratis, Ion N; Horvath, Judit; Herrmann, François R; Bouras, Constantin; Kövari, Enikö

    2016-04-01

    Recent accumulated evidence indicates that episodic memory impairments could be part of the initial clinical expression of frontotemporal dementia (FTD). An early study on this issue was carried out by Constantinidis and colleagues in 1974, but it was subsequently overlooked for a long period of time. The scope of the present research was: (a) to explore the presence of early episodic memory impairments in the entire population of neuropathologically confirmed FTD patients from the Geneva brain collection; and (b) to expand the present insight on the association between the initial symptomatology and various characteristics, namely gender, age at onset, disease duration, and presence of Pick body neuropathology. A careful review of the records of 50 FTD patients hospitalized at the Department of Psychiatry of the Bel-Air Hospital, Geneva, Switzerland, from 1929 to 1999, was conducted. Further in-depth neuropathological analysis with novel immunohistological methods was carried out in 37 of the cases. The data showed that memory impairments were the first clinical symptom in several of the patients. In addition, this specific phenotypic expression of FTD was associated with the female gender, advanced age, and positive Pick body neuropathology. The current findings give the opportunity to historically vindicate the early work of Constantinidis and colleagues. In addition, the novel observations about the association of episodic memory impairments with the female gender and positive Pick body neuropathology add to the existing knowledge about this phenotypic expression of FTD.

  13. Awareness of Cytomegalovirus Infection among Pregnant Women in Geneva, Switzerland: A Cross-sectional Study

    PubMed Central

    Willame, Alexia; Blanchard-Rohner, Geraldine; Combescure, Christophe; Irion, Olivier; Posfay-Barbe, Klara; Martinez de Tejada, Begoña

    2015-01-01

    Background: Cytomegalovirus (CMV) is the most frequent cause of congenital infection and commonly associated with sensorineural deficit. At present, there is neither prophylaxis nor treatment during pregnancy. The objective of this study was to evaluate the level of awareness regarding CMV infection and its consequences in women delivering at the University of Geneva Hospitals (Geneva, Switzerland). Methods: The study consisted of a validated questionnaire completed by women in the immediate postpartum period. Results: The questionnaire was completed by 59% (314/528) of delivering women. Only 39% (123/314) knew about CMV and 19.7% (62/314) had received information about preventive measures. Women were more aware about other congenital diseases, such as toxoplasmosis (87%); human immunodeficiency virus (99%); syphilis (85.5%); rubella (92.3%); and group B Streptococcus (63%). Factors associated with CMV awareness were Swiss nationality, high education level, employment in health care or with children, and being followed by an obstetrician. Regarding quality of information, few were aware of the main CMV complications (deafness, 25.2%; mental retardation, 34.5%). Among those informed about CMV, most (74.6%) knew about preventive measures. Among these, 82.5% thought that these were easily applicable. Conclusions: Most women are unaware of CMV infection and its potential risks during pregnancy. It is crucial to improve CMV information given to pregnant women to prevent the risks for the fetus/newborn. PMID:26633451

  14. Demonstration of membrane aeration panels: City of Geneva Wastewater Treatment Plant. Final report

    SciTech Connect

    1995-01-01

    This report describes the design, construction, and testing of membrane aeration panels at the Marsh Creek wastewater treatment plant (WWTP) in Geneva, NY. The operators at the Geneva plant have undertaken a long-term program to upgrade wastewater treatment processes and lower operating costs. The aging mechanical surface aerators at the Marsh Creek treatment plant were replaced by a state-of-the-art membrane panel system. This fine-bubble diffused air system offers higher oxygen transfer efficiency than surface aerators or other types of fine-bubble diffused-air systems. The project had four objectives: to decrease the amount of electricity used at the plant for aeration; to enable the plant`s existing aeration basins to accommodate higher organic loads and/or nitrify the wastewater should the need arise; to provide an even distribution of dissolved oxygen within the aeration basins to enhance biological wastewater treatment activity; and to provide technical data to assess the performance of the membrane panel system versus other forms of wastewater aeration.

  15. Brain-computer interaction research at the Computer Vision and Multimedia Laboratory, University of Geneva.

    PubMed

    Pun, Thierry; Alecu, Teodor Iulian; Chanel, Guillaume; Kronegg, Julien; Voloshynovskiy, Sviatoslav

    2006-06-01

    This paper describes the work being conducted in the domain of brain-computer interaction (BCI) at the Multimodal Interaction Group, Computer Vision and Multimedia Laboratory, University of Geneva, Geneva, Switzerland. The application focus of this work is on multimodal interaction rather than on rehabilitation, that is how to augment classical interaction by means of physiological measurements. Three main research topics are addressed. The first one concerns the more general problem of brain source activity recognition from EEGs. In contrast with classical deterministic approaches, we studied iterative robust stochastic based reconstruction procedures modeling source and noise statistics, to overcome known limitations of current techniques. We also developed procedures for optimal electroencephalogram (EEG) sensor system design in terms of placement and number of electrodes. The second topic is the study of BCI protocols and performance from an information-theoretic point of view. Various information rate measurements have been compared for assessing BCI abilities. The third research topic concerns the use of EEG and other physiological signals for assessing a user's emotional status.

  16. Questioning the Consensus Definition of Validity

    ERIC Educational Resources Information Center

    Newton, Paul E.

    2012-01-01

    This focus article provided the author with an opportunity to unpack the consensus definition of validity and to explore its implications in the light of recent debates. He proposed an elaboration of the consensus definition, which was intended to express the spirit of the "Standards for Educational and Psychological Testing" with increased…

  17. Posterior Probabilities for a Consensus Ordering.

    ERIC Educational Resources Information Center

    Fligner, Michael A.; Verducci, Joseph S.

    1990-01-01

    The concept of consensus ordering is defined, and formulas for exact and approximate posterior probabilities for consensus ordering are developed under the assumption of a generalized Mallows' model with a diffuse conjugate prior. These methods are applied to a data set concerning 98 college students. (SLD)

  18. Eastern Canadian Gastrointestinal Cancer Consensus Conference 2014

    PubMed Central

    Tsvetkova, E.; Sud, S.; Aucoin, N.; Biagi, J.; Burkes, R.; Samson, B.; Brule, S.; Cripps, C.; Colwell, B.; Falkson, C.; Dorreen, M.; Goel, R.; Halwani, F.; Maroun, J.; Michaud, N.; Tehfe, M.; Thirlwell, M.; Vickers, M.; Asmis, T.

    2015-01-01

    The annual Eastern Canadian Colorectal Cancer Consensus Conference was held in Montreal, Quebec, 23–25 October 2014. Expert radiation, medical, and surgical oncologists and pathologists involved in the management of patients with gastrointestinal malignancies participated in presentations and discussions resulting in consensus statements on such hot topics as management of neuroendocrine tumours, advanced and metastatic pancreatic cancer, and metastatic colorectal cancer. PMID:26300681

  19. Management of Pediatric Malignant Germ Cell Tumors: ICMR Consensus Document.

    PubMed

    Agarwala, Sandeep; Mitra, Aparajita; Bansal, Deepak; Kapoor, Gauri; Vora, Tushar; Prasad, Maya; Chinnaswamy, Girish; Arora, Brijesh; Radhakrishnan, Venkatraman; Laskar, Siddharth; Kaur, Tanvir; Dhaliwal, Rupinder Singh; Rath, G K; Bakhshi, Sameer

    2017-04-01

    With the introduction of cisplatin, the outcome of children with malignant germ cell tumors (MGCT) has improved to nearly 90% 5 year survival. Over the years, through the results of various multinational co-operative trials, the chemotherapy and surgical guidelines for both the gonadal and extra-gonadal MGCTs have been refined to decrease the early and late morbidities and at the same time improve survival. Introduction of risk categorization has further added to this effort. There has been no recommendation on how the children with malignant germ cell tumors should be treated in India. The current manuscript is written with the objective of developing a consensus guideline for practitioners at a National level. Based on extensively reviewed literature and personal experience of the major pediatric oncology centres in India, the ICMR Expert group has made recommendations for management of children with MGCT India.

  20. [Argentine consensus on the treatment of bipolar disorders].

    PubMed

    Vázquez, Gustavo Héctor; Strejilevich, Sergio; García Bonetto, Gerardo; Cetkovich-Bakmas, Marcelo; Zaratiegui, Rodolfo; Lagomarsino, Alejandro; Goldchluk, Aníbal; Kalina, Eduardo; Herbst, Luis; Gutiérrez, Benigno

    2005-01-01

    The consensus guidelines of argentine experts in the treatment of bipolar disorders are the result of three days of work of the 10 main local experts under the organization of the Argentine Association of Biological Psychiatry (AAPB). It was adopted a mixed criterion for its preparation: all the recent data of the evidence medicine based published until now were discussed and were balanced with the knowledge acquired from clinical experience of the local experts on the bipolar field. It presents general recommendations and suggested therapeutic sequences for the phase of maintenance, the manic/hypomanic or mixed episode and the depressive episode. These have been divided according to the classification in type I and II; with or without rapid cycling. Since the group of experts identified the delay and miss-diagnoses like the most important barrier for a suitable treatment enclosed a series of recommendations for differential diagnosis of bipolar disorders.

  1. Consensus statements on occupational therapy ethics related to driving.

    PubMed

    Slater, Deborah Yarett

    2014-04-01

    As part of an expert panel convened to examine evidence and practice related to diverse aspects of driving evaluation and rehabilitation, consensus statements were developed on ethics. This paper provides context for the ethical obligation of practitioners to assess and make recommendations about the ability of clients to safely perform the activity of driving. It highlights key articles from the literature as well as principles from the Occupational Therapy Code of Ethics and Ethics Standards (2010). The statements support the importance of identifying impairments affecting driving, which could result in harm to the client as well as to the public. The ethical and professional obligation of practitioners to evaluate, make recommendations, and possibly report and/or refer to a driver rehabilitation specialist for further services is reinforced.

  2. OARSI Clinical Trials Recommendations for Hip Imaging in Osteoarthritis

    PubMed Central

    Gold, Garry E.; Cicuttini, Flavia; Crema, Michel D.; Eckstein, Felix; Guermazi, Ali; Kijowski, Richard; Link, Thomas M.; Maheu, Emmanuel; Martel-Pelletier, Johanne; Miller, Colin G.; Pelletier, Jean-Pierre; Peterfy, Charles G.; Potter, Hollis G.; Roemer, Frank W.; Hunter, David. J

    2015-01-01

    Imaging of hip in osteoarthritis (OA) has seen considerable progress in the past decade, with the introduction of new techniques that may be more sensitive to structural disease changes. The purpose of this expert opinion, consensus driven recommendation is to provide detail on how to apply hip imaging in disease modifying clinical trials. It includes information on acquisition methods/ techniques (including guidance on positioning for radiography, sequence/protocol recommendations/ hardware for MRI); commonly encountered problems (including positioning, hardware and coil failures, artifacts associated with various MRI sequences); quality assurance/ control procedures; measurement methods; measurement performance (reliability, responsiveness, and validity); recommendations for trials; and research recommendations. PMID:25952344

  3. Inhaled treatment of COPD: a Delphi consensus statement

    PubMed Central

    Ninane, Vincent; Corhay, Jean-Louis; Germonpré, Paul; Janssens, Wim; Joos, Guy F; Liistro, Giuseppe; Vincken, Walter; Gurdain, Sandra; Vanvlasselaer, Evelyne; Lehouck, An

    2017-01-01

    Background Global Initiative for Chronic Obstructive Lung Disease (GOLD) global strategy (2015) provides guidance for the treatment of chronic obstructive pulmonary disease (COPD) with different first-choice options per GOLD category without specification. Objectives To evaluate the level of medical experts’ consensus on their preferred first-choice treatment within different COPD categories. Methods A two-round Delphi Panel consisting of 15 questions was completed by Belgian pulmonologists (n=31) and European (n=10) COPD experts. Results Good consensus was reached by both expert groups for long-acting bronchodilators instead of short-acting bronchodilators as first-choice treatment in GOLD A. Single bronchodilation with long-acting muscarinic antagonist (LAMA) was preferred over long-acting β2-agonist (LABA) and LABA/LAMA as first-choice treatment in GOLD B and GOLD C. For GOLD D patients based on the forced expiratory volume in 1 second (FEV1)<50%, a very good consensus was reached for LAMA/LABA as first-choice treatment. For GOLD D patients based on frequent or severe exacerbations, there was a good consensus for LABA/LAMA/inhaled corticosteroids (ICS) as first choice in the Belgian group. According to the European experts, both LABA/LAMA and LABA/LAMA/ICS could be the first choice for these patients. Conclusion Belgian and European experts recommend long-acting bronchodilators as first-choice treatment. Treatment containing ICS was found only appropriate in patients with FEV1<50% and ≥2 moderate exacerbations or 1 severe exacerbation/year. PMID:28293106

  4. Identifying genetics and genomics nursing competencies common among published recommendations.

    PubMed

    Greco, Karen E; Salveson, Catherine

    2009-10-01

    The purpose of this article is to identify published recommendations for genetics and genomics competencies or curriculum for nurses in the United States and to summarize genetic and genomic nursing competencies based on common themes among these documents. A review of the literature between January 1998 and June 2008 was conducted. Efforts were also made to access the gray literature. Five consensus documents describing recommendations for genetics and genomics competencies for nurses meeting inclusion criteria were analyzed. Twelve genetics and genomics competencies were created based on common themes among the recommendations. These competencies include: demonstrate an understanding of basic genetic and genomic concepts, provide and explain genetic and genomic information, refer to appropriate genetics professionals and services, and identify the limits of one's own genetics and genomics expertise. The competencies represent fundamental genetics and genomics competencies for nurses on the basis of common themes among several consensus recommendations identified in the literature.

  5. Myalgic encephalomyelitis: International Consensus Criteria

    PubMed Central

    Carruthers, B M; van de Sande, M I; De Meirleir, K L; Klimas, N G; Broderick, G; Mitchell, T; Staines, D; Powles, A C P; Speight, N; Vallings, R; Bateman, L; Baumgarten-Austrheim, B; Bell, D S; Carlo-Stella, N; Chia, J; Darragh, A; Jo, D; Lewis, D; Light, A R; Marshall-Gradisbik, S; Mena, I; Mikovits, J A; Miwa, K; Murovska, M; Pall, M L; Stevens, S

    2011-01-01

    , Japan; A. Kirchenstein Institute of Microbiology and Virology, Riga Stradins University, Riga, Latvia; Department of Biochemistry & Basic Medical Sciences, Washington State University, Portland, OR; Department of Sports Sciences, University of the Pacific, Stockton, CA USA). Myalgic encephalomyelitis: International Consensus Criteria (Review). J Intern Med 2011; 270: 327–338. The label ‘chronic fatigue syndrome’ (CFS) has persisted for many years because of the lack of knowledge of the aetiological agents and the disease process. In view of more recent research and clinical experience that strongly point to widespread inflammation and multisystemic neuropathology, it is more appropriate and correct to use the term ‘myalgic encephalomyelitis’ (ME) because it indicates an underlying pathophysiology. It is also consistent with the neurological classification of ME in the World Health Organization’s International Classification of Diseases (ICD G93.3). Consequently, an International Consensus Panel consisting of clinicians, researchers, teaching faculty and an independent patient advocate was formed with the purpose of developing criteria based on current knowledge. Thirteen countries and a wide range of specialties were represented. Collectively, members have approximately 400 years of both clinical and teaching experience, authored hundreds of peer-reviewed publications, diagnosed or treated approximately 50 000 patients with ME, and several members coauthored previous criteria. The expertise and experience of the panel members as well as PubMed and other medical sources were utilized in a progression of suggestions/drafts/reviews/revisions. The authors, free of any sponsoring organization, achieved 100% consensus through a Delphi-type process. The scope of this paper is limited to criteria of ME and their application. Accordingly, the criteria reflect the complex symptomatology. Operational notes enhance clarity and specificity by providing guidance in the

  6. Report from the 13th Annual Western Canadian Gastrointestinal Cancer Consensus Conference; Calgary, Alberta; September 8–10, 2011

    PubMed Central

    Vickers, M.M.; Pasieka, J.; Dixon, E.; McEwan, S.; McKay, A.; Renouf, D.; Schellenberg, D.; Ruether, D.

    2012-01-01

    The 13th annual Western Canadian Gastrointestinal Cancer Consensus Conference was held in Calgary, Alberta, September 8–10, 2011. Health care professionals involved in the care of patients with gastrointestinal cancers participated in presentation and discussion sessions for the purposes of developing the recommendations presented here. This consensus statement addresses current issues in the management neuroendocrine tumours and locally advanced pancreatic cancer. PMID:23300370

  7. Changing practice patterns in the management of primary breast cancer: Consensus Development Program.

    PubMed Central

    Kosecoff, J; Kanouse, D E; Brook, R H

    1990-01-01

    In the last decade, new knowledge has emerged concerning the efficacy of treatment for breast cancer. For that reason, the National Institutes of Health devoted a consensus conference to this topic. To determine whether the consensus conference had influenced practice patterns, and to evaluate the level of quality of care given to women with breast cancer, the medical records of 573 patients treated in ten hospitals throughout the state of Washington were abstracted and analyzed. Results showed no changes with respect to the consensus conference's recommendations for use of a total mastectomy with axillary dissection or the use of a two-step procedure in which the biopsy is performed first and therapeutic options are discussed before a definitive surgery is undertaken. Analyses of quality of care issues not addressed by the consensus conference revealed that 4 percent of the sample were explicitly staged preoperatively and 29 percent postoperatively and that little changed over time in the use of sentinel laboratory tests. These results also show that consensus recommendations will not necessarily change physicians' behavior even where change is possible, and that quality of care in diagnosis and treatment of breast cancer still needs to be addressed. PMID:2254089

  8. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 4: seminal vesicles and lymph nodes.

    PubMed

    Berney, Daniel M; Wheeler, Thomas M; Grignon, David J; Epstein, Jonathan I; Griffiths, David F; Humphrey, Peter A; van der Kwast, Theo; Montironi, Rodolfo; Delahunt, Brett; Egevad, Lars; Srigley, John R

    2011-01-01

    The 2009 International Society of Urological Pathology Consensus Conference in Boston made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to the infiltration of tumor into the seminal vesicles and regional lymph nodes were coordinated by working group 4. There was a consensus that complete blocking of the seminal vesicles was not necessary, although sampling of the junction of the seminal vesicles and prostate was mandatory. There was consensus that sampling of the vas deferens margins was not obligatory. There was also consensus that muscular wall invasion of the extraprostatic seminal vesicle only should be regarded as seminal vesicle invasion. Categorization into types of seminal vesicle spread was agreed by consensus to be not necessary. For examination of lymph nodes, there was consensus that special techniques such as frozen sectioning were of use only in high-risk cases. There was no consensus on the optimal sampling method for pelvic lymph node dissection specimens, although there was consensus that all lymph nodes should be completely blocked as a minimum. There was also a consensus that a count of the number of lymph nodes harvested should be attempted. In view of recent evidence, there was consensus that the diameter of the largest lymph node metastasis should be measured. These consensus decisions will hopefully clarify the difficult areas of pathological assessment in radical prostatectomy evaluation and improve the concordance of research series to allow more accurate assessment of patient prognosis.

  9. Consensus Paper: Cerebellum and Emotion.

    PubMed

    Adamaszek, M; D'Agata, F; Ferrucci, R; Habas, C; Keulen, S; Kirkby, K C; Leggio, M; Mariën, P; Molinari, M; Moulton, E; Orsi, L; Van Overwalle, F; Papadelis, C; Priori, A; Sacchetti, B; Schutter, D J; Styliadis, C; Verhoeven, J

    2017-04-01

    Over the past three decades, insights into the role of the cerebellum in emotional processing have substantially increased. Indeed, methodological refinements in cerebellar lesion studies and major technological advancements in the field of neuroscience are in particular responsible to an exponential growth of knowledge on the topic. It is timely to review the available data and to critically evaluate the current status of the role of the cerebellum in emotion and related domains. The main aim of this article is to present an overview of current facts and ongoing debates relating to clinical, neuroimaging, and neurophysiological findings on the role of the cerebellum in key aspects of emotion. Experts in the field of cerebellar research discuss the range of cerebellar contributions to emotion in nine topics. Topics include the role of the cerebellum in perception and recognition, forwarding and encoding of emotional information, and the experience and regulation of emotional states in relation to motor, cognitive, and social behaviors. In addition, perspectives including cerebellar involvement in emotional learning, pain, emotional aspects of speech, and neuropsychiatric aspects of the cerebellum in mood disorders are briefly discussed. Results of this consensus paper illustrate how theory and empirical research have converged to produce a composite picture of brain topography, physiology, and function that establishes the role of the cerebellum in many aspects of emotional processing.

  10. Recommendations on practice of conditioned pain modulation (CPM) testing.

    PubMed

    Yarnitsky, D; Bouhassira, D; Drewes, A M; Fillingim, R B; Granot, M; Hansson, P; Landau, R; Marchand, S; Matre, D; Nilsen, K B; Stubhaug, A; Treede, R D; Wilder-Smith, O H G

    2015-07-01

    Protocols for testing conditioned pain modulation (CPM) vary between different labs/clinics. In order to promote research and clinical application of this tool, we summarize the recommendations of interested researchers consensus meeting regarding the practice of CPM and report of its results.

  11. Early Intervention/Early Childhood Special Education: Recommended Practices.

    ERIC Educational Resources Information Center

    Odom, Samuel L.; McLean, Mary E.

    This book's 15 chapters elaborate on specific educational practices in early intervention and early childhood special education, recommended by a task force of the Council for Exceptional Children's Division of Early Childhood. The selected practices were identified through a process involving analysis of expert opinions, professional consensus,…

  12. Were Holocene large slumps in Lake Geneva off the city of Lausanne caused by fault activity?

    NASA Astrophysics Data System (ADS)

    Correia Demand, Jehanne; Marillier, François; Kremer, Katrina; Girardclos, Stéphanie

    2014-05-01

    Lake Geneva is set in an area where glacier advances and retreats have carved Tertiary Molasse rocks in front of the Alpine units. Glacial and lacustrine sediments have accumulated in the lake on top of the Molasse. Within Holocene sedimentary layers, seismic studies in the central part of Lake Geneva ("Grand-Lac") have shown the presence of several mass transport deposits (MTD). A large one, MTD A, is observed off the city of Lausanne. The depth of the associated failure scars (100 m water depth), its volume (~ 0.13 km3), and the occurrence of other smaller MTDs that were possibly co-deposited with MTD A point to the occurrence of a major slide event in the lake, most likely associated with an earthquake. Based on 14C dating, the sediment age model for MTD A gives an age interval of 1865-1608 BC (Kremer et al. 2014). To resolve the details of the MTDs off Lausanne, and to better understand its geological context different seismic systems were used. These were a 3.5 KHz pinger with a theoretical vertical resolution of 0.15 m and a multichannel system with water-gun or air-gun seismic sources with vertical resolution of 0.6 m and 1.1 m, respectively. After a first pass processing, the multi-channel data were reprocessed in order to take into account the shape of the streamer in the water and to enhance the results of migration. In addition to typical seismic images of MTDs observed in other alpine lakes such as chaotic or transparent seismic character between well-organized reflections, two intriguing positive water-bottom topographic features associated with apparent sub-vertical offsets are revealed by the seismic data. They are located in the near vicinity of the depot centers of the MTDs and conspicuously located near faults in the Tertiary Molasse. These are thrust faults that are offset by small strike-slip faults, and we suggest that the positive topographic features are linked to a compressive component within the sediments due to displacements along these

  13. Gyre formation within embayments of a large lake (Lake Geneva, Switzerland)

    NASA Astrophysics Data System (ADS)

    Razmi, A.; Barry, D.; Bouffard, D.; Le Dantec, N.; Lemmin, U.; Wuest, A.

    2013-12-01

    Numerical simulations were carried out to examine gyre formation within open, wide lacustrine embayments. The present study was motivated by observed differences in gyre formation within two open and wide embayments (located at Vidy and Morges in Lake Geneva, Switzerland). These two embayments are located within about 3 km of each other on the northern shore of Lake Geneva, and are subjected to similar pelagic currents. Vidy is deeper and has a greater aspect ratio than Morges. The flow field in the embayments was modeled using a previously validated 3D hydrodynamic model (Delft3D-FLOW). The model solved the Reynolds-Averaged Navier-Stokes equations, combined with a k-ɛ turbulence closure in σ (lakebed-following) coordinates. Our study focused on the influence of the embayment geometry on the (uniform) longshore (pelagic) current, specifically the occurrence and magnitude of circulation within the embayment. We built a set of numerical experiments using synthetic embayments, and systematically examined embayment geometry, thereby capturing the differences between the Vidy and Morges embayments. The numerical experiments considered single rectilinear embayments with different aspect ratios (i.e., 1-6), depth, shore-parallel flow rates, and embayment corner angle between 0°-50°. The circulation magnitude changes abruptly for an angle of about 40°. Embayments with angles greater than 40° have much greater circulation then those with lesser angles, other factors remaining the same. Of the factors considered (i.e., aspect ratio, offshore current velocity, corner angle, bottom slope, and viscosity), bottom slope and the viscosity have almost no impact on embayment circulation. For uniform offshore current patterns, gyres form in embayments with large aspect ratios (up to ~3). For the Vidy and Morges embayments, the results showed that gyre formation is more likely in Morges due to its smaller aspect ratio, a finding that is supported by field data gathered in

  14. 76 FR 48941 - Alabama & Florida Railway Co., Inc.-Abandonment Exemption-in Geneva, Coffee, and Covington...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-09

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Surface Transportation Board Alabama & Florida Railway Co., Inc.--Abandonment Exemption--in Geneva, Coffee..., Coffee and Covington Counties, Ala. The line constitutes A&F's entire rail system and traverses...

  15. Duplication in the Domestica Apple Collection within the USDA-ARS National Plant Germplasm System in Geneva, New York

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The USDA-ARS National Plant Germplasm System maintains more than 1300 named accessions of Malus x domestica in a field collection in Geneva, NY. Seven microsatellite markers (GD12, GD15, GD96, GD103, GD142, GD147, GD162) were used to identify duplicates within a set of 1240 domestica accessions with...

  16. Whole-genome sequences of 13 endophytic bacteria isolated from shrub willow (salix) grown in geneva, new york.

    PubMed

    Gan, Huan You; Gan, Han Ming; Savka, Michael A; Triassi, Alexander J; Wheatley, Matthew S; Smart, Lawrence B; Fabio, Eric S; Hudson, André O

    2014-05-08

    Shrub willow, Salix spp. and hybrids, is an important bioenergy crop. Here we report the whole-genome sequences and annotation of 13 endophytic bacteria from stem tissues of Salix purpurea grown in nature and from commercial cultivars and Salix viminalis × Salix miyabeana grown in bioenergy fields in Geneva, New York.

  17. 2015 Progress Report – Evaluation of the Cornell-Geneva Apple Rootstocks and Other Promising Apple Rootstocks

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A number of new apple rootstocks from the Cornell/USDA apple rootstock breeding project, located at Geneva, NY which are resistant to fire blight are rapidly becoming available to the industry. These rootstocks are also dwarfing, tolerant to replant disease and productive. Data on cumulative yield...

  18. Expert consensus v. evidence-based approaches in the revision of the DSM.

    PubMed

    Kendler, K S; Solomon, M

    2016-08-01

    The development of DSM-III through DSM-5 has relied heavily on expert consensus. In this essay, we provide an historical and critical perspective on this process. Over the last 40 years, medicine has struggled to find appropriate methods for summarizing research results and making clinical recommendations. When such recommendations are issued by authorized organizations, they can have widespread influence (i.e. DSM-III and its successors). In the 1970s, expert consensus conferences, led by the NIH, reviewed research about controversial medical issues and successfully disseminated results. However, these consensus conferences struggled with aggregating the complex available evidence. In the 1990s, the rise of evidence-based medicine cast doubt on the reliability of expert consensus. Since then, medicine has increasingly relied on systematic reviews, as developed by the evidence-based medicine movement, and advocated for their early incorporation in expert consensus efforts. With the partial exception of DSM-IV, such systematic evidence-based reviews have not been consistently integrated into the development of the DSMs, leaving their development out of step with the larger medical field. Like the recommendations made for the NIH consensus conferences, we argue that the DSM process should be modified to require systematic evidence-based reviews before Work Groups make their assessments. Our suggestions - which would require leadership and additional resources to set standards for appropriate evidence hierarchies, carry out systematic reviews, and upgrade the group process - should improve the objectivity of the DSM, increase the validity of its results, and improve the reception of any changes in nosology.

  19. A consensus approach to improving patient adherence and persistence with topical treatment for actinic keratosis

    PubMed Central

    Stockfleth, Eggert; Peris, Ketty; Guillen, Carlos; Cerio, Rino; Basset-Seguin, Nicole; Foley, Peter; Sanches, José; Culshaw, Alex; Erntoft, Sandra; Lebwohl, Mark

    2015-01-01

    Background Topical therapy is important in the treatment of actinic keratosis, but guidance for improving adherence/persistence during topical therapy is still lacking. Objectives To utilize expert consensus to generate a list of recommendations to improve real-world efficacy when prescribing topical therapy for actinic keratosis. Methods An expert panel of eight dermatologists was convened to generate recommendations based on facilitated discussion and consensus generation using a modified Delphi session. The recommendations were ratified with the expert panel. Results Facilitated discussion generated 31 issues within five themes, which were prioritized using expert voting. Consensus was achieved on the importance of short and simple treatment regimens for maximizing patient compliance, physician awareness of the progression of actinic keratosis to squamous cell carcinoma, provision of appropriate patient information, and the use of effective communication strategies to educate physicians about actinic keratosis. Based on these key findings, eight recommendations were generated. Conclusions The recommendations will assist physicians when prescribing topical actinic keratosis therapy. Further research should focus on the types of patient outcomes that are influenced by the characteristics of topical field therapy. PMID:25865875

  20. [Therapeutic drug monitoring (TDM) of psychotropic drugs: a consensus guideline of the AGNP-TDM group].

    PubMed

    Baumann, P; Hiemke, C; Ulrich, S; Eckermann, G; Kuss, H L; Laux, G; Müller-Oerlingenhausen, B; Rao, M L; Riederer, P; Zernig, G

    2006-05-24

    In psychiatry, therapeutic drug monitoring (TDM) is an established procedure for most psychotropic drugs. However, as its use in everyday clinical practice is far from optimal, the AGNP-TDM group has worked out consensus guidelines to assist psychiatrists and laboratories involved in drug analysis. Based on a thorough analysis of available literature, 5 levels of recommendation were defined with regard to TDM of psychoactive drugs, from 1) (strongly recommended) to 5) (not recommended). A list of indications for TDM, alone or in combination with pharmacogenetic tests is presented. Instructions are given with regard to preparation of TDM, analytical procedures, reporting and interpretation of results and the use of information for patient treatment. Using the consensus guideline will help to ensure optimal clinical benefit of TDM.

  1. Canadian society of transplantation consensus workshop on cytomegalovirus management in solid organ transplantation final report.

    PubMed

    Preiksaitis, Jutta K; Brennan, Daniel C; Fishman, Jay; Allen, Upton

    2005-02-01

    The Canadian Society of Transplantation sponsored a Cytomegalovirus (CMV) Consensus Working Group that met on March 19, 2003. The objectives of this group were to determine the current burden of CMV-associated disease in the setting of solid organ transplantation in Canada, make recommendations regarding optimal strategies for the diagnosis, treatment and prevention of CMV infection and disease, highlight gaps in knowledge and outline priorities for research and other initiatives that might further reduce the burden of CMV-associated effects in this setting. This report summarizes the recommendations of the working group including ratings of the strength of evidence supporting the recommendations.

  2. The Gene, Environment Association Studies consortium (GENEVA): maximizing the knowledge obtained from GWAS by collaboration across studies of multiple conditions.

    PubMed

    Cornelis, Marilyn C; Agrawal, Arpana; Cole, John W; Hansel, Nadia N; Barnes, Kathleen C; Beaty, Terri H; Bennett, Siiri N; Bierut, Laura J; Boerwinkle, Eric; Doheny, Kimberly F; Feenstra, Bjarke; Feingold, Eleanor; Fornage, Myriam; Haiman, Christopher A; Harris, Emily L; Hayes, M Geoffrey; Heit, John A; Hu, Frank B; Kang, Jae H; Laurie, Cathy C; Ling, Hua; Manolio, Teri A; Marazita, Mary L; Mathias, Rasika A; Mirel, Daniel B; Paschall, Justin; Pasquale, Louis R; Pugh, Elizabeth W; Rice, John P; Udren, Jenna; van Dam, Rob M; Wang, Xiaojing; Wiggs, Janey L; Williams, Kayleen; Yu, Kai

    2010-05-01

    Genome-wide association studies (GWAS) have emerged as powerful means for identifying genetic loci related to complex diseases. However, the role of environment and its potential to interact with key loci has not been adequately addressed in most GWAS. Networks of collaborative studies involving different study populations and multiple phenotypes provide a powerful approach for addressing the challenges in analysis and interpretation shared across studies. The Gene, Environment Association Studies (GENEVA) consortium was initiated to: identify genetic variants related to complex diseases; identify variations in gene-trait associations related to environmental exposures; and ensure rapid sharing of data through the database of Genotypes and Phenotypes. GENEVA consists of several academic institutions, including a coordinating center, two genotyping centers and 14 independently designed studies of various phenotypes, as well as several Institutes and Centers of the National Institutes of Health led by the National Human Genome Research Institute. Minimum detectable effect sizes include relative risks ranging from 1.24 to 1.57 and proportions of variance explained ranging from 0.0097 to 0.02. Given the large number of research participants (N>80,000), an important feature of GENEVA is harmonization of common variables, which allow analyses of additional traits. Environmental exposure information available from most studies also enables testing of gene-environment interactions. Facilitated by its sizeable infrastructure for promoting collaboration, GENEVA has established a unified framework for genotyping, data quality control, analysis and interpretation. By maximizing knowledge obtained through collaborative GWAS incorporating environmental exposure information, GENEVA aims to enhance our understanding of disease etiology, potentially identifying opportunities for intervention.

  3. Estimation of the reproductive number of the Spanish flu epidemic in Geneva, Switzerland.

    PubMed

    Chowell, G; Ammon, C E; Hengartner, N W; Hyman, J M

    2006-11-10

    The 1918 influenza pandemic known as the "Spanish Flu" has been the worst in recent history with estimated worldwide mortality ranging from 20 to 100 million deaths. Using epidemic modeling and hospital notification data during the 1918 influenza pandemic in the Canton of Geneva, Switzerland, we estimated the reproductive numbers of the first and second waves of influenza infection to be R(1)=1.49 (95% CI: 1.45-1.53) and R(2)=3.75 (95% CI: 3.57-3.93), respectively. Our estimates indicate that containment of the next influenza pandemic could require strict interventions that include effective isolation strategies in hospitals and reductions in the susceptibility of the general population.

  4. Testing an unconventional mortality information source in the canton of Geneva Switzerland.

    PubMed

    Kabengele Mpinga, Emmanuel; Delley, Véronique; Jeannot, Emilien; Cohen, Joachim; Chastonay, Philippe; Wilson, Donna M

    2013-09-26

    Mortality data are often unavailable, incomplete, and difficult to access for research and other purposes. Gaps in mortality data reports, particularly those detailing place of death, deprive healthcare professionals, decision-makers, and many others of the information that is needed to plan, implement, and evaluate interventions designed for purposes such as to assist people in achieving their preferred death place or reduce hospital utilization. Alternative methods of collecting reliable and valid data on death place may be needed. Our study primarily compared mortality data from a conventional information system (Federal Statistical Office) with mortality data collected using an unconventional system (funeral homes) over a 6-year period (2005-10) for the canton of Geneva Switzerland. Only a small average difference (4.8%) in death incidence was found. Death place data comparisons were also useful. This study suggests that the unconventional data from funeral homes provides reasonably reliable, valid, timely, and useful mortality data.

  5. [Neurodevelopmental follow-up of premature children in Lausanne and Geneva].

    PubMed

    Bickle Graz, M; Cevey-Macherel, M; Forcada-Guex, M; Truttmann, A; Ha-Vinh Leuchter, R; Sizonenko, S; Huppi, P S; Borradori Tolsa, C

    2011-02-23

    Preterm children born before 32 weeks of gestation represent 1% of the annual births in Switzerland, and are the most at risk of neurodevelopmental disabilities. A neurological surveillance is thus implemented in the neonatal units, and multidisciplinary neurodevelopmental follow-up is offered to all our preterm patients. The follow-up clinics of the University hospitals in Lausanne and Geneva follow the Swiss guidelines for follow-up. An extended history and neurological examination is taken at each appointment, and a standardized test of development is performed. These examinations, which take place between the ages of 3 months and 9 years old, allow the early identification and treatment of developmental disorders frequent in this population, such as motor, cognitive or behavioral disorders, as well as the monitoring of the quality of neonatal care.

  6. High-resolution seismic stratigraphy of an Holocene lacustrine delta in western Lake Geneva (Switzerland)

    USGS Publications Warehouse

    Baster, I.; Girardclos, S.; Pugin, A.; Wildi, W.

    2003-01-01

    A high-resolution seismic survey was conducted in western Lake Geneva on a small delta formed by the Promenthouse, the Asse and the Boiron rivers. This dataset provides information on changes in the geometry and sedimentation patterns of this delta from Late-glacial to Present. The geometry of the deposits of the lacustrine delta has been mapped using 300-m spaced grid lines acquired with a 12 kHz Echosounder subbottom profiler. A complete three dimensional image of the sediment architecture was reconstructed through seismic stratigraphic analysis. Six different delta lobes have been recognized in the prodelta area. Depositional centers and lateral extension of the delta have changed through time, indicating migration and fluctuation of river input as well as changes in lake currents and wind regime from the time of glacier retreat to the Present. The delta slope is characterized by a high instability causing stumps developing and by the accumulation of biogenic gas that prevents seismic penetration.

  7. Seasonal Spatial Patterns of Surface Water Temperature, Surface Heat Fluxes and Meteorological Forcing Over Lake Geneva

    NASA Astrophysics Data System (ADS)

    Irani Rahaghi, A.; Lemmin, U.; Bouffard, D.; Riffler, M.; Wunderle, S.; Barry, D. A.

    2015-12-01

    In many lakes, surface heat flux (SHF) is the most important component controlling the lake's energy content. Accurate methods for the determination of SHF are valuable for water management, and for use in hydrological and meteorological models. Large lakes, not surprisingly, are subject to spatially and temporally varying meteorological conditions, and hence SHF. Here, we report on an investigation for estimating the SHF of a large European lake, Lake Geneva. We evaluated several bulk formulas to estimate Lake Geneva's SHF based on different data sources. A total of 64 different surface heat flux models were realized using existing representations for different heat flux components. Data sources to run the models included meteorological data (from an operational numerical weather prediction model, COSMO-2) and lake surface water temperature (LSWT, from satellite imagery). Models were calibrated at two points in the lake for which regular depth profiles of temperature are available, and which enabled computation of the total heat content variation. The latter, computed for 03.2008-12.2012, was the metric used to rank the different models. The best calibrated model was then selected to calculate the spatial distribution of SHF. Analysis of the model results shows that evaporative and convective heat fluxes are the dominant terms controlling the spatial pattern of SHF. The former is significant in all seasons while the latter plays a role only in fall and winter. Meteorological observations illustrate that wind-sheltering, and to some extent relative humidity variability, are the main reasons for the observed large-scale spatial variability. In addition, both modeling and satellite observations indicate that, on average, the eastern part of the lake is warmer than the western part, with a greater temperature contrast in spring and summer than in fall and winter whereas the SHF spatial splitting is stronger in fall and winter. This is mainly due to negative heat flux

  8. Frequency Determination for the Slowly Pulsating B Star, HD21071, From Combined Geneva and Stromgren Photometry

    NASA Astrophysics Data System (ADS)

    Sims, Melissa; Dukes, R. J., Jr.

    2006-12-01

    This project is comparison of several studies done on the variable star HD21071, which was previously determined to be Slowly Pulsating B star by Waelkens, et. al. (Astron. Astrophys. 330, 215-221, 1998) with a suggested period of .841 day (1.19 c d-1). Several later studies including Mills, L. R., et. al. (BAAS 31, 1482, 1999) and Andrews, J. E, et. al. (AAS Meeting 203, #83.14, 2003) confirmed the .841 period and tentatively suggested other possible periods based on new data, including 0.704 day (1.42 c d-1), 0.775 day (1.29 c d-1), and 1.14 day (0.878 c d-1) periods. This project merges Geneva V data and data from the y filter from the FCAPT data in the Stromgren uvby system by using a bilinear transformation from Harmanec et. al. (Astron. Astrophys. 369, 1140, 2001). Frequencies were determined using the Period04 program, which utilizes a least square fitting technique, to determine frequencies in the two data sets separately. We then analyzed the merged data set resulting in confirmation of the periods found in the individual data sets. The reality of the these frequencies was tested using multiple methods including least squares analysis and a check of the signal to noise ratio. We would like to thank Connie Aerts and Peter De Cat for providing the Geneva data as well as a copy of their preliminary analysis of this data. This work has been supported by NSF Grant AST-0071260 & AST-050755

  9. Consensus of population systems with community structures.

    PubMed

    Wang, Jing; Wu, Bin; Wang, Long; Fu, Feng

    2008-11-01

    Multicommunity population systems may reach a consensus state where the fractions of each species in different communities agree on a common value. In this paper, by analyzing the evolutionary dynamics based on an extended replicator equation incorporating community effects, the consensus problem of population systems with n communities is studied. In particular, the simple case of two communities is investigated in detail. In general, for n communities, a sufficient and necessary condition for population systems to reach a consensus of coexistent state is provided. Regarding the population dynamics for the four different types of games, whether the population systems can achieve consensus is determined. The dynamics of community-structured populations shows richer features than nonstructured populations, and some nontrivial phenomena arising from different community-structured population systems are illustrated with concrete numerical examples.

  10. Leader selection for fast consensus in networks

    NASA Astrophysics Data System (ADS)

    Wang, Ying; Yang, Wen; Wang, Lin; Wang, Xiaofan

    2015-12-01

    This paper considers a leader-follower system with the aim to select an optimal leader so as to drive the remaining nodes to reach the desired consensus with the fastest convergence speed. An index called consensus centrality (CC) is proposed to quantify how fast a leader could guide the network to achieve the desired consensus. The experiment results explored the big similarities between the distributions of CC and degree in the network, which suggest that the suboptimal leader selected by the maximum degree can approximately approach the optimal leader in heterogeneous networks. Combining the degree-based k-shell decomposition with consensus centrality, a leader selection algorithm is proposed to reduce the computational complexity in large-scale networks. Finally, the convergence time of an equivalent discrete-time model is given to illustrate the properties of the suboptimal solutions.

  11. Diagnostic and therapeutic consensus on acromegaly.

    PubMed

    Doga, M; Bonadonna, S; Gola, M; Nuzzo, M; Giustina, A

    2005-01-01

    In February 1999 and May 2000, two workshops were held in Cortina, Italy and Montecarlo, respectively, to develop a consensus defining the diagnosis and treatment of acromegaly. The workshops were sponsored by the Italian Society of Endocrinology, the Pituitary Society and European Neuroendocrine Association. Partecipants from all over the world included endocrinologists, neurosurgeons and radiotherapists skilled in the management of acromegaly. This review paper summarizes the main points of the two consensus statements published following these two workshops.

  12. [Educational objectives in the new interdisciplinary subject "Rehabilitation, Physical Medicine, Naturopathic Techniques" under the 9th Revision of the Licensing Regulations for Doctors--consensus recommendations of the German Society for Rehabilitative Sciences and the German Society for Physical Medicine and Rehabilitation].

    PubMed

    Mau, W; Gülich, M; Gutenbrunner, C; Lampe, B; Morfeld, M; Schwarzkopf, S R; Smolenski, U C

    2004-12-01

    In October 2003 the 9 (th) revision of the Federal Medical Training Regulations (Approbationsordnung) came into effect. The new compulsory interdisciplinary subject "Rehabilitation, Physical Medicine, Naturopathic Treatment" offers the opportunity to teach all students in comprehensive concepts of Rehabilitation such as the International Classification of Functioning, Disability and Health (ICF) of the WHO and the new book 9 of the German Social Code (SGB 9), as well as Physical Medicine and Naturopathic Treatment. Since the content of this new subject has not been defined up to date a joint task force of the German Society of Rehabilitation Science and the German Society of Physical Medicine and Rehabilitation was founded in order to recommend teaching standards. As part of these teaching standards educational objectives are introduced in this article. They should guide the persons in charge of teaching the subject in the medical faculties. In some areas the students should acquire profound abilities and skills in addition to knowledge. The medical faculties may focus on different educational targets according to their individual teaching profile.

  13. [Familial combined hyperlipidemia: consensus document].

    PubMed

    Mata, Pedro; Alonso, Rodrigo; Ruíz-Garcia, Antonio; Díaz-Díaz, Jose L; González, Noemí; Gijón-Conde, Teresa; Martínez-Faedo, Ceferino; Morón, Ignacio; Arranz, Ezequiel; Aguado, Rocío; Argueso, Rosa; Perez de Isla, Leopoldo

    2014-10-01

    Familial combined hyperlipidemia (FCH) is a frequent disorder associated with premature coronary artery disease. It is transmitted in an autosomal dominant manner, although there is not a unique gene involved. The diagnosis is performed using clinical criteria, and variability in lipid phenotype and family history of hyperlipidemia are necessaries. Frequently, the disorder is associated with type2 diabetes mellitus, arterial hypertension and central obesity. Patients with FCH are considered as high cardiovascular risk and the lipid target is an LDL-cholesterol <100mg/dL, and <70mg/dL if cardiovascular disease or type 2 diabetes are present. Patients with FCH require lipid lowering treatment using potent statins and sometimes, combined lipid-lowering treatment. Identification and management of other cardiovascular risk factors as type 2 diabetes and hypertension are fundamental to reduce cardiovascular disease burden. This document gives recommendations for the diagnosis and global treatment of patients with FCH directed to specialists and general practitioners.

  14. Rotorcraft aviation icing research requirements: Research review and recommendations

    NASA Technical Reports Server (NTRS)

    Peterson, A. A.; Dadone, L.; Bevan, A.

    1981-01-01

    The status of rotorcraft icing evaluation techniques and ice protection technology was assessed. Recommendations are made for near and long term icing programs that describe the needs of industry. These recommended programs are based on a consensus of the major U.S. helicopter companies. Specific activities currently planned or underway by NASA, FAA and DOD are reviewed to determine relevance to the overall research requirements. New programs, taking advantage of current activities, are recommended to meet the long term needs for rotorcraft icing certification.

  15. [Recommendations for respiratory support in the newborn (I)].

    PubMed

    2008-05-01

    The recommendations included in this document will be part a series of updated reviews of the literature on respiratory support in the newborn infant. These recommendations are structured into twelve modules, with the first three modules being developed in this work. Each module it is the result of a consensus process amongst all members of the Surfactant and Respiratory Group of the Spanish Society of Neonatology. They represent a summary of the published papers on each specific topic and of the clinical experience of each one of the members of the group. Each module includes a summary of the scientific evidence available, graded into four levels of recommendations.

  16. [Consensus on the diagnostic and therapeutic approach to pain and stress in the newborn].

    PubMed

    Lemus-Varela, María de Lourdes; Sola, Augusto; Golombek, Sergio; Baquero, Hernando; Borbonet, Daniel; Dávila-Aliaga, Carmen; Del Moral, Teresa; Lara-Flores, Gabriel; Lima-Rogel, María Victoria; Neira-Safi, Freddy; Natta, Diego; Oviedo-Barrantes, Ada; Rodríguez, Susana

    2014-11-01

    Pain and stress experienced by the newborn have not been addressed adequately. Infants in neonatal intensive care units often undergo painful and stressful invasive procedures, and inappropriate treatment increases morbidity and mortality. At the 5th Clinical Consensus of the Ibero-American Society of Neonatology, 32 neonatologists from the region were invited to establish recommendations for the diagnosis and treatment of neonatal pain and stress. Key themes were explored based on the best scientific evidence available in indexed databases. All attendees participated actively in a meeting in Santiago, Chile, with the objective of reaching a consensus on recommendations and conclusions. Pain and neonatal stress affect neurological development and long-term behavior and require timely diagnosis and appropriate management and treatment, including the use of drugs with an appropriate balance between effectiveness and toxicity. The Consensus emphasized the importance of assessing pain in the newborn from a multidimensional viewpoint, and provided recommendations on the indications and limitations for an individualized pharmacological therapy. The use of analgesics has precise indications but also important limitations; there is a lack of randomized studies in newborns, and adverse effects need to be considered. Nonpharmacological measures to mitigate pain were proposed. Stress management should begin in the delivery room, including maternal contact, stimulus reduction and the implementation of intervention reduction protocols. Recommendations for improving clinical practices related to neonatal pain and stress are presented.

  17. Standard operating procedures for ESPEN guidelines and consensus papers.

    PubMed

    Bischoff, Stephan C; Singer, Pierre; Koller, Michael; Barazzoni, Rocco; Cederholm, Tommy; van Gossum, André

    2015-12-01

    The ESPEN Guideline standard operating procedures (SOP) is based on the methodology provided by the Association of Scientific Medical Societies of Germany (AWMF), the Scottish Intercollegiate Guidelines Network (SIGN), and the Centre for Evidence-based Medicine at the University of Oxford. The SOP is valid and obligatory for all future ESPEN-sponsored guideline projects aiming to generate high-quality guidelines on a regular basis. The SOP aims to facilitate the preparation of guideline projects, to streamline the consensus process, to ensure quality and transparency, and to facilitate the dissemination and publication of ESPEN guidelines. To achieve this goal, the ESPEN Guidelines Editorial board (GEB) has been established headed by two chairmen. The GEB will support and supervise the guideline processes and is responsible for the strategic planning of ESPEN guideline activities. Key elements of the SOP are the generation of well-built clinical questions according to the PICO system, a systemic literature search, a classification of the selected literature according to the SIGN evidence levels providing an evidence table, and a clear and straight-forward consensus procedure consisting of online voting's and a consensus conference. Only experts who meet the obligation to disclosure any potential conflict of interests and who are not employed by the Industry can participate in the guideline process. All recommendations will be graded according to the SIGN grading and novel outcome models besides biomedical endpoints. This approach will further extent the leadership of ESPEN in creating up-to-date and suitable for implementation guidelines and in sharing knowledge on malnutrition and clinical nutrition.

  18. International Spine Radiosurgery Consortium Consensus Guidelines for Target Volume Definition in Spinal Stereotactic Radiosurgery

    SciTech Connect

    Cox, Brett W.; Spratt, Daniel E.; Lovelock, Michael; Bilsky, Mark H.; Lis, Eric; Ryu, Samuel; Sheehan, Jason; Gerszten, Peter C.; Chang, Eric; Gibbs, Iris; Soltys, Scott; Sahgal, Arjun; Deasy, Joe; Flickinger, John; Quader, Mubina; Mindea, Stefan; and others

    2012-08-01

    Purpose: Spinal stereotactic radiosurgery (SRS) is increasingly used to manage spinal metastases. However, target volume definition varies considerably and no consensus target volume guidelines exist. This study proposes consensus target volume definitions using common scenarios in metastatic spine radiosurgery. Methods and Materials: Seven radiation oncologists and 3 neurological surgeons with spinal radiosurgery expertise independently contoured target and critical normal structures for 10 cases representing common scenarios in metastatic spine radiosurgery. Each set of volumes was imported into the Computational Environment for Radiotherapy Research. Quantitative analysis was performed using an expectation maximization algorithm for Simultaneous Truth and Performance Level Estimation (STAPLE) with kappa statistics calculating agreement between physicians. Optimized confidence level consensus contours were identified using histogram agreement analysis and characterized to create target volume definition guidelines. Results: Mean STAPLE agreement sensitivity and specificity was 0.76 (range, 0.67-0.84) and 0.97 (range, 0.94-0.99), respectively, for gross tumor volume (GTV) and 0.79 (range, 0.66-0.91) and 0.96 (range, 0.92-0.98), respectively, for clinical target volume (CTV). Mean kappa agreement was 0.65 (range, 0.54-0.79) for GTV and 0.64 (range, 0.54-0.82) for CTV (P<.01 for GTV and CTV in all cases). STAPLE histogram agreement analysis identified optimal consensus contours (80% confidence limit). Consensus recommendations include that the CTV should include abnormal marrow signal suspicious for microscopic invasion and an adjacent normal bony expansion to account for subclinical tumor spread in the marrow space. No epidural CTV expansion is recommended without epidural disease, and circumferential CTVs encircling the cord should be used only when the vertebral body, bilateral pedicles/lamina, and spinous process are all involved or there is extensive metastatic

  19. A Research and Discussion Note: The Macrostructure of Consensus Statements

    ERIC Educational Resources Information Center

    Mungra, Philippa

    2007-01-01

    This research note presents a preliminary study of the structure of consensus statements (CSs). The consensus statement is released by a medical association after calling a consensus development conference on a pertinent medical issue. Using a very small corpus, this note attempts to characterize consensus statements by identifying the sequence of…

  20. Chemotherapy drug shortages in pediatric oncology: a consensus statement.

    PubMed

    Decamp, Matthew; Joffe, Steven; Fernandez, Conrad V; Faden, Ruth R; Unguru, Yoram

    2014-03-01

    Shortages of essential drugs, including critical chemotherapy drugs, have become commonplace. Drug shortages cost significant time and financial resources, lead to adverse patient outcomes, delay clinical trials, and pose significant ethical challenges. Pediatric oncology is particularly susceptible to drug shortages, presenting an opportunity to examine these ethical issues and provide recommendations for preventing and alleviating shortages. We convened the Working Group on Chemotherapy Drug Shortages in Pediatric Oncology (WG) and developed consensus on the core ethical values and practical actions necessary for a coordinated response to the problem of shortages by institutions, agencies, and other stakeholders. The interdisciplinary and multiinstitutional WG included practicing pediatric hematologist-oncologists, nurses, hospital pharmacists, bioethicists, experts in emergency management and public policy, legal scholars, patient/family advocates, and leaders of relevant professional societies and organizations. The WG endorsed 2 core ethical values: maximizing the potential benefits of effective drugs and ensuring equitable access. From these, we developed 6 recommendations: (1) supporting national polices to prevent shortages, (2) optimizing use of drug supplies, (3) giving equal priority to evidence-based uses of drugs whether they occur within or outside clinical trials, (4) developing an improved clearinghouse for sharing drug shortage information, (5) exploring the sharing of drug supplies among institutions, and (6) developing proactive stakeholder engagement strategies to facilitate prevention and management of shortages. Each recommendation includes an ethical rationale, action items, and barriers that must be overcome. Implemented together, they provide a blueprint for effective and ethical management of drug shortages in pediatric oncology and beyond.

  1. Chemotherapy Drug Shortages in Pediatric Oncology: A Consensus Statement

    PubMed Central

    DeCamp, Matthew; Joffe, Steven; Fernandez, Conrad V.; Faden, Ruth R.

    2014-01-01

    Shortages of essential drugs, including critical chemotherapy drugs, have become commonplace. Drug shortages cost significant time and financial resources, lead to adverse patient outcomes, delay clinical trials, and pose significant ethical challenges. Pediatric oncology is particularly susceptible to drug shortages, presenting an opportunity to examine these ethical issues and provide recommendations for preventing and alleviating shortages. We convened the Working Group on Chemotherapy Drug Shortages in Pediatric Oncology (WG) and developed consensus on the core ethical values and practical actions necessary for a coordinated response to the problem of shortages by institutions, agencies, and other stakeholders. The interdisciplinary and multiinstitutional WG included practicing pediatric hematologist-oncologists, nurses, hospital pharmacists, bioethicists, experts in emergency management and public policy, legal scholars, patient/family advocates, and leaders of relevant professional societies and organizations. The WG endorsed 2 core ethical values: maximizing the potential benefits of effective drugs and ensuring equitable access. From these, we developed 6 recommendations: (1) supporting national polices to prevent shortages, (2) optimizing use of drug supplies, (3) giving equal priority to evidence-based uses of drugs whether they occur within or outside clinical trials, (4) developing an improved clearinghouse for sharing drug shortage information, (5) exploring the sharing of drug supplies among institutions, and (6) developing proactive stakeholder engagement strategies to facilitate prevention and management of shortages. Each recommendation includes an ethical rationale, action items, and barriers that must be overcome. Implemented together, they provide a blueprint for effective and ethical management of drug shortages in pediatric oncology and beyond. PMID:24488741

  2. Management of chronic urticaria in Asia: 2010 AADV consensus guidelines

    PubMed Central

    2012-01-01

    This guideline is a result of a consensus reached during the 19th Asian-Australasian Regional Conference of Dermatology by the Asian Academy of Dermatology and Venereology Study Group in collaboration with the League of Asian Dermatological Societies in 2010. Urticaria has a profound impact on the quality of life in Asia and the need for effective treatment is required. In line with the EAACI/GA2LEN/EDF/WAO guideline for the management of urticaria the recommended first-line treatment is new generation, non-sedating H1-antihistamines. If standard dosing is ineffective, increasing the dosage up to four-fold is recommended. For patients who do not respond to a four-fold increase in dosage of non-sedating H1-antihistamines, it is recommended that therapies such as H2-antihistamine, leukotriene antagonist, and cyclosporine A should be added to the antihistamine treatment. In the choice of second-line treatment, both their costs and risk/benefit profiles are the most important considerations. PMID:22701866

  3. [Consensus on Systemic Arterial Hypertension In México].

    PubMed

    Rosas-Peralta, Martín; Palomo-Piñón, Silvia; Borrayo-Sánchez, Gabriela; Madrid-Miller, Alejandra; Almeida-Gutiérrez, Eduardo; Galván-Oseguera, Héctor; Magaña-Serrano, José Antonio; Saturno-Chiu, Guillermo; Ramírez-Arias, Erick; Santos-Martínez, Efrén; Díaz-Díaz, Enrique; Salgado-Pastor, Selene Janette; Morales-Mora, Gerardo; Medina-Concebida, Luz Elena; Mejía-Rodríguez, Oliva; Pérez-Ruiz, Claudia Elsa; Chapa-Mejía, Luis Raúl; Álvarez-Aguilar, Cleto; Pérez-Rodríguez, Gilberto; Castro-Martínez, María Guadalupe; López-Bárcena, Joaquín; Paniagua-Sierra, José Ramón

    2016-01-01

    This Consenso Nacional de Hipertensión Arterial Sistémica (National Consensus on Systemic Arterial Hypertension) brings together experiences and joint work of 79 specialists who have been in contact with the patient affected by systemic arterial hypertension. All concepts here presented were outlined on the basis of the real world practice of Mexican hypertensive population. The consensus was developed under strict methodological guidelines. The Delphi technique was applied in two rounds for the development of an appropriate statistical analysis of the concepts exposed by all the specialists, who posed key questions, later developed by the panel of experts of the Hospital de Cardiología, and specialists from the Centro Médico Nacional. Several angles of this illness are shown: detection, diagnosis, pathophysiology, classification, treatment and prevention. The evidence analysis was carried out using PRISMA method. More than 600 articles were reviewed, leaving only the most representative in the references. This document concludes with practical and useful recommendations for the three levels of health care of our country.

  4. [Second Brazilian Consensus Conference on Helicobacter pylori infection].

    PubMed

    Coelho, Luiz Gonzaga Vaz; Zaterka, Schlioma

    2005-01-01

    Significant progress has been obtained since the First Brazilian Consensus Conference on H. pylori Infection held in 1995, in Belo Horizonte, MG, and justify a second meeting to establish updated guidelines on the current management of H. pylori infection. The Second Brazilian Consensus Conference on H. pylori Infection was organized by the Brazilian Federation of Gastroenterology and Brazilian Nucleus for the Study of Helicobacter and took place on June, 19-20, 2004 in São Paulo, SP. Thirty six delegates coming from 15 different Brazilian states including gastroenterologists, pathologists, microbiologists and pediatricians undertook the meeting. The participants were allocated in one the five main topics of the meeting: H. pylori and dyspepsia, H. pylori and NSAIDs, H. pylori and gastroesophageal reflux disease, H. pylori treatment, and H. pylori retreatment. Seventy per cent and more votes were considered as acceptance for the final statement. The results were presented during a special session on the VI Brazilian Week of Digestive System, in Recife, PE (October 2004), and this publication represents the summary of the main recommendations and conclusions emerged from the meeting.

  5. Harmonization of quality indicators in laboratory medicine. A preliminary consensus.

    PubMed

    Plebani, Mario; Astion, Michael L; Barth, Julian H; Chen, Wenxiang; de Oliveira Galoro, César A; Escuer, Mercedes Ibarz; Ivanov, Agnes; Miller, Warren G; Petinos, Penny; Sciacovelli, Laura; Shcolnik, Wilson; Simundic, Ana-Maria; Sumarac, Zorica

    2014-07-01

    Quality indicators (QIs) are fundamental tools for enabling users to quantify the quality of all operational processes by comparing it against a defined criterion. QIs data should be collected over time to identify, correct, and continuously monitor defects and improve performance and patient safety by identifying and implementing effective interventions. According to the international standard for medical laboratories accreditation, the laboratory shall establish and periodically review QIs to monitor and evaluate performance throughout critical aspects of pre-, intra-, and post-analytical processes. However, while some interesting programs on indicators in the total testing process have been developed in some countries, there is no consensus for the production of joint recommendations focusing on the adoption of universal QIs and common terminology in the total testing process. A preliminary agreement has been achieved in a Consensus Conference organized in Padua in 2013, after revising the model of quality indicators (MQI) developed by the Working Group on "Laboratory Errors and Patient Safety" of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). The consensually accepted list of QIs, which takes into consideration both their importance and applicability, should be tested by all potentially interested clinical laboratories to identify further steps in the harmonization project.

  6. The APOSTEL recommendations for reporting quantitative optical coherence tomography studies

    PubMed Central

    Cruz-Herranz, Andrés; Balk, Lisanne J.; Oberwahrenbrock, Timm; Saidha, Shiv; Martinez-Lapiscina, Elena H.; Lagreze, Wolf A.; Schuman, Joel S.; Villoslada, Pablo; Calabresi, Peter; Balcer, Laura; Petzold, Axel; Green, Ari J.; Paul, Friedemann; Brandt, Alexander U.

    2016-01-01

    Objective: To develop consensus recommendations for reporting of quantitative optical coherence tomography (OCT) study results. Methods: A panel of experienced OCT researchers (including 11 neurologists, 2 ophthalmologists, and 2 neuroscientists) discussed requirements for performing and reporting quantitative analyses of retinal morphology and developed a list of initial recommendations based on experience and previous studies. The list of recommendations was subsequently revised during several meetings of the coordinating group. Results: We provide a 9-point checklist encompassing aspects deemed relevant when reporting quantitative OCT studies. The areas covered are study protocol, acquisition device, acquisition settings, scanning protocol, funduscopic imaging, postacquisition data selection, postacquisition data analysis, recommended nomenclature, and statistical analysis. Conclusions: The Advised Protocol for OCT Study Terminology and Elements recommendations include core items to standardize and improve quality of reporting in quantitative OCT studies. The recommendations will make reporting of quantitative OCT studies more consistent and in line with existing standards for reporting research in other biomedical areas. The recommendations originated from expert consensus and thus represent Class IV evidence. They will need to be regularly adjusted according to new insights and practices. PMID:27225223

  7. Multidisciplinary Management of Mastocytosis: Nordic Expert Group Consensus.

    PubMed

    Broesby-Olsen, Sigurd; Dybedal, Ingunn; Gülen, Theo; Kristensen, Thomas K; Møller, Michael B; Ackermann, Leena; Sääf, Maria; Karlsson, Maria A; Agertoft, Lone; Brixen, Kim; Hermann, Pernille; Stylianou, Eva; Mortz, Charlotte G; Torfing, Trine; Havelund, Troels; Sander, Birgitta; Bergström, Anna; Bendix, Marie; Garvey, Lene H; Bjerrum, Ole Weis; Valent, Peter; Bindslev-Jensen, Carsten; Nilsson, Gunnar; Vestergaard, Hanne; Hägglund, Hans

    2016-06-15

    Mastocytosis is a heterogeneous group of diseases defined by an increased number and accumulation of mast cells, and often also by signs and symptoms of mast cell activation. Disease subtypes range from indolent to rare aggressive forms. Mastocytosis affects people of all ages and has been considered rare; however, it is probably underdiagnosed with potential severe implications. Diagnosis can be challenging and symptoms may be complex and involve multiple organ-systems. In general it is advised that patients should be referred to centres with experience in the disease offering an individualized, multidisciplinary approach. We present here consensus recommendations from a Nordic expert group for the diagnosis and general management of patients with mastocytosis.

  8. Italian consensus conference for colonic diverticulosis and diverticular disease.

    PubMed

    Cuomo, Rosario; Barbara, Giovanni; Pace, Fabio; Annese, Vito; Bassotti, Gabrio; Binda, Gian Andrea; Casetti, Tino; Colecchia, Antonio; Festi, Davide; Fiocca, Roberto; Laghi, Andrea; Maconi, Giovanni; Nascimbeni, Riccardo; Scarpignato, Carmelo; Villanacci, Vincenzo; Annibale, Bruno

    2014-10-01

    The statements produced by the Consensus Conference on Diverticular Disease promoted by GRIMAD (Gruppo Italiano Malattia Diverticolare, Italian Group on Diverticular Diseases) are reported. Topics such as epidemiology, risk factors, diagnosis, medical and surgical treatment of diverticular disease (DD) in patients with uncomplicated and complicated DD were reviewed by a scientific board of experts who proposed 55 statements graded according to level of evidence and strength of recommendation, and approved by an independent jury. Each topic was explored focusing on the more relevant clinical questions. Comparison and discussion of expert opinions, pertinent statements and replies to specific questions, were presented and approved based on a systematic literature search of the available evidence. Comments were added explaining the basis for grading the evidence, particularly for controversial areas.

  9. Italian consensus conference for colonic diverticulosis and diverticular disease

    PubMed Central

    Barbara, Giovanni; Pace, Fabio; Annese, Vito; Bassotti, Gabrio; Binda, Gian Andrea; Casetti, Tino; Colecchia, Antonio; Festi, Davide; Fiocca, Roberto; Laghi, Andrea; Maconi, Giovanni; Nascimbeni, Riccardo; Scarpignato, Carmelo; Villanacci, Vincenzo; Annibale, Bruno

    2014-01-01

    The statements produced by the Consensus Conference on Diverticular Disease promoted by GRIMAD (Gruppo Italiano Malattia Diverticolare, Italian Group on Diverticular Diseases) are reported. Topics such as epidemiology, risk factors, diagnosis, medical and surgical treatment of diverticular disease (DD) in patients with uncomplicated and complicated DD were reviewed by a scientific board of experts who proposed 55 statements graded according to level of evidence and strength of recommendation, and approved by an independent jury. Each topic was explored focusing on the more relevant clinical questions. Comparison and discussion of expert opinions, pertinent statements and replies to specific questions, were presented and approved based on a systematic literature search of the available evidence. Comments were added explaining the basis for grading the evidence, particularly for controversial areas. PMID:25360320

  10. Therapeutic monitoring of clozapine in Australia: the need for consensus.

    PubMed

    Oo, Thein Z; Wilson, John F; Naidoo, Divania; Chetty, Manoranjenni

    2006-10-01

    In the absence of well-defined guidelines for the monitoring of plasma concentrations of clozapine, this study examined the practices of seven laboratories from four states in Australia. Laboratories analyzed 5 freeze-dried serum samples containing a mixture of clozapine and norclozapine in varying concentrations and the measurement data were analyzed for accuracy and precision. Additional information on laboratory practices was obtained through questionnaire responses. Measurement precision amongst the laboratories was good but there were significant differences in the accuracy of measurements from one laboratory. There were differences in the ranges for which assays had been validated and in suggested therapeutic ranges. These differences could have a significant impact on the interpretation of measured concentrations and patient care, and emphasize the need for consensus in this area. Repeat concentration measurements are recommended in the case of drug concentration measurements that are inconsistent with clinical observations or previous measurements.

  11. Core outcome domains for controlled trials and clinical recordkeeping in eczema: international multiperspective Delphi consensus process.

    PubMed

    Schmitt, Jochen; Langan, Sinéad; Stamm, Tanja; Williams, Hywel C

    2011-03-01

    There is wide variation in the use of outcome measures for eczema. We performed a three-stage web-based international Delphi exercise to develop consensus-based sets of core outcome domains for eczema for "controlled trials" and "clinical recordkeeping". A total of 57 individuals from four stakeholder groups (consumers, clinical experts, regulatory agency representatives, and journal editors) representing 13 countries were asked to rate the importance of 19 outcome domains for eczema and to choose which domains should be included in two core sets of outcomes. Forty-six individuals (81%) participated. Participants received standardized feedback, including the group median, interquartile range, and previous responses, and the assessment was repeated in two subsequent rounds. We defined consensus a priori if at least 60% of the members of at least three stakeholder groups, including consumers, recommended domain inclusion in the core set. Consensus was achieved for inclusion of symptoms, physician-assessed clinical signs, and a measurement for long-term control of flares in the core set of outcome domains for eczema trials. We recommend including these three core outcomes in future eczema trials in order to enhance clinical interpretability and to enable meta-analyses across different studies. For recordkeeping, consensus was reached to regularly monitor eczema symptoms in clinical practice. Future work is needed to select which existing or new scales should be used to measure the domains identified as relevant for the core set.

  12. Paroxysmal sympathetic hyperactivity after acquired brain injury: consensus on conceptual definition, nomenclature, and diagnostic criteria.

    PubMed

    Baguley, Ian J; Perkes, Iain E; Fernandez-Ortega, Juan-Francisco; Rabinstein, Alejandro A; Dolce, Giuliano; Hendricks, Henk T

    2014-09-01

    A syndrome of paroxysmal, episodic sympathetic hyperactivity after acquired brain injury has been recognized for almost 60 years. This project sought to simplify the confused nomenclature for the condition (>31 eponyms) and simplify the nine overlapping sets of diagnostic criteria. A consensus-developed questionnaire based on a systematic review of the literature was circulated to a widely representative, international expert group utilizing a Delphi approach. Diagnostic criteria were dropped if group consensus failed to agree on their relative importance, with a goal of reaching a Cronbach α of 0.8 (suitable for research purposes). The resulting criteria were combined into an assessment measure for clinical and research settings. The consensus group recommend that the term "paroxysmal sympathetic hyperactivity" replace previous terms to describe the "syndrome, recognised in a subgroup of survivors of severe acquired brain injury, of simultaneous, paroxysmal transient increases in sympathetic [elevated heart rate, blood pressure, respiratory rate, temperature, sweating] and motor [posturing] activity." An 11 point probabilistic diagnostic scale was developed with reference to published criteria, yielding an acceptable Cronbach α of 0.8. These 11 items were proceduralized and combined with a symptom severity index to produce a diagnostic tool for use with adults (the paroxysmal sympathetic hyperactivity assessment measure [PSH-AM]). Development of a pediatric version of the scale and further research into the validity of the PSH-AM is recommended. The consensus position builds on previous literature to establish diagnostic definitions and criteria, an important move to standardize research and management of this condition.

  13. International consensus on (ICON) anaphylaxis

    PubMed Central

    2014-01-01

    ICON: Anaphylaxis provides a unique perspective on the principal evidence-based anaphylaxis guidelines developed and published independently from 2010 through 2014 by four allergy/immunology organizations. These guidelines concur with regard to the clinical features that indicate a likely diagnosis of anaphylaxis -- a life-threatening generalized or systemic allergic or hypersensitivity reaction. They also concur about prompt initial treatment with intramuscular injection of epinephrine (adrenaline) in the mid-outer thigh, positioning the patient supine (semi-reclining if dyspneic or vomiting), calling for help, and when indicated, providing supplemental oxygen, intravenous fluid resuscitation and cardiopulmonary resuscitation, along with concomitant monitoring of vital signs and oxygenation. Additionally, they concur that H1-antihistamines, H2-antihistamines, and glucocorticoids are not initial medications of choice. For self-management of patients at risk of anaphylaxis in community settings, they recommend carrying epinephrine auto-injectors and personalized emergency action plans, as well as follow-up with a physician (ideally an allergy/immunology specialist) to help prevent anaphylaxis recurrences. ICON: Anaphylaxis describes unmet needs in anaphylaxis, noting that although epinephrine in 1 mg/mL ampules is available worldwide, other essentials, including supplemental oxygen, intravenous fluid resuscitation, and epinephrine auto-injectors are not universally available. ICON: Anaphylaxis proposes a comprehensive international research agenda that calls for additional prospective studies of anaphylaxis epidemiology, patient risk factors and co-factors, triggers, clinical criteria for diagnosis, randomized controlled trials of therapeutic interventions, and measures to prevent anaphylaxis recurrences. It also calls for facilitation of global collaborations in anaphylaxis research. In addition to confirming the alignment of major anaphylaxis guidelines, ICON

  14. Methane ebullition and fate in the Rhone River delta (Lake Geneva) and its subaquatic canyons

    NASA Astrophysics Data System (ADS)

    DelSontro, T.; Sollberger, S.; Corella, J. P.; Wehrli, B.; Girardclos, S.; Anselmetti, F. S.; Senn, D. B.

    2012-04-01

    There is increasing knowledge of the importance of inland waters as sources of atmospheric methane, but widespread variability of total and individual emission pathway estimates remain in the literature. Ebullition (bubbling) is potentially the most efficient transport mechanism from water bodies, particularly shallow water bodies or regions thereof where bubbles have the greatest chance of reaching the atmosphere. However, ebullition is one of the least monitored of the pathways, mostly due to its stochastic nature making it difficult to constrain spatially and temporally. Recent studies on a large tropical reservoir and a large European lake have shown that river deltas (i.e., localized regions of high allochthonous organic matter sedimentation) can be methane ebullition hot spots emitting disproportionate amounts of methane. Therefore, in this study the Rhone River delta (one Europe's most important rivers) of the Alp's largest lake, Lake Geneva, was surveyed for methane ebullition using a bubble size-calibrated 120 kHz split-beam echosounder (Simrad EK60, Kongsberg Maritime). Extensive ebullition was found in the current river delta complex in proximity to the river inflow, which is the major source of atmospheric methane emission in the entire 100 km2 deltaic region. As water depths approach 100 m, ebullition is constrained to only the top levees of the 10 - 40 m high walls of the subaquatic canyon formed by the plunging Rhone River. Ebullition occurs to depths over 200 m on the levee of the active canyon, where CTD profiles suggest that Rhone River water does extend that far along the canyon. As bubble dissolution depends on release depth and bubble size, which was estimated from the rise velocity of deep bubbles, it was discovered that bubbles emitted from 100 m or deeper would not reach the surface; thus the proximal delta remains the prominent methane source. Eight other canyons exist in the delta complex, of which two non-active canyons formed by previous

  15. Tracing partners of patients with syphilis infection remains challenging: experience of Geneva Hospital.

    PubMed

    de Lorenzi, Caroline; Angèle, Gayet-Ageron; Martine, Girard-Strohbach; Laurence, Toutous Trellu

    2017-01-01

    Syphilis has been reinstated on the list of notifiable diseases in Switzerland since 2006 and the active management of sexual partners is encouraged to avoid reinfection. However, contact tracing has yielded unsatisfactory results and the incidence of syphilis remains important, especially in high-risk populations. The aim of this study was to compare the proportions of notified sexual partners of patients diagnosed with syphilis by the laboratories of Geneva University Hospitals (HUG) with those diagnosed in private laboratories (non-HUG) and to assess the risk factors for no notification to sexual partners. All syphilis cases notified to the Office of the Surgeon General in Geneva (Switzerland) between 1 January 2011 and 31 December 2013 were analysed. The proportions of partner notification (PN) between HUG and non-HUG laboratories were compared by Chi square test and the main risk factors for no notification to sexual partners were assessed by binomial log-linear regression. Among a total of 720 notifications reported, 244 cases were diagnosed with contagious syphilis stages and 263 with non-contagious stages (i.e. successfully treated patients with or late latent cases). Overall, PN was higher among contagious than non-contagious cases (58.4% versus 31.0%; p = 0.030) and it was significantly higher in the non-HUG compared to the HUG group (75.9% versus 50.0%, respectively; p < 0.001). Risk factors independently associated with no notification to sexual partners were the place of diagnosis (risk ratio [RR] 1.66; 95% confidence interval [CI] 1.21-2.27 for HUG versus non-HUG, respectively), age >45 years (RR 1.36; 95% CI: 1.05-1.76) and if the patient had received treatment for syphilis (RR 1.91; 95% CI: 1.38-2.66). Our results illustrate the difficulty of contact tracing in syphilis infection and the necessity to improve this crucial part of sexually transmitted infection management.

  16. Contrasted effects of climate change on temperate large lakes oxygen-depletion (Lakes Geneva, Bourget, Annecy)

    NASA Astrophysics Data System (ADS)

    Jenny, Jean-Philippe; Arnaud, Fabien; Dorioz, Jean-Marcel; Alric, Benjamin; Sabatier, Pierre; Perga, Marie-Elodie

    2013-04-01

    Among manifestations of the entry in a new geological era -The Anthropocene- marked by the fingerprinting of human activities in global ecology, the development of persistent zones of oxygen-depletion particularly threatens aquatic ecosystems. This results in a loss of fisheries, a loss of biodiversity, an alteration of food-webs and even, in extreme cases, mass mortality of fauna1. Whereas hypoxia -defined as dissolved oxygen ≤2 mg/l- has long been considered as a consequence of the sole eutrophication, recent studies showed it also depends on climate change. Despite basic processes of oxygen-depletion are well-known, till now no study evaluated the contrasted effects of climate changes on a long-term perspective. Here we show that climate change paced fluctuation of hypoxia in 3 large lakes (Lake Geneva, Lake Bourget and Lake Annecy) that were previously disturbed by unprecedented nutrient input. Our approach couples century-scale paleo-reconstruction of 1) hypoxia, 2) flood regime and 3) nutrient level, thanks to an exceptional 80 sediment core data collection taken in three large lakes (Geneva, Bourget, Annecy), and monitoring data. Our results show that volume of hypoxia can be annually estimated according to varve records through large lakes. Quantitative additive models were then used to identify and hierarchy environmental forcings on hypoxia. Flood regime and air temperatures hence appeared as significant forcing factors of hypolimnetic hypoxia. Noticeably, their effects are highly contrasted between lakes, depending on specific lake morphology and local hydrological regime. We hence show that greater is the lake specific river discharge the more is the control of winter mixing and the lower is the control of thermal stratification on oxygen depletion. Our study confirms that the perturbation of food web due to nutrient input led to a higher vulnerability of aquatic ecosystems to climate change. We further show specific hydrological regime play a crucial

  17. Late Glacial and Holocene Geomagnetic secular variation in Western Lake Geneva (Switzerland)

    NASA Astrophysics Data System (ADS)

    Baster, I.; Heller, F.; Egli, R.; Rachoud-Schneider, A. M.; Wildi, W.

    2003-04-01

    Lacustrine sediments can provide excellent records of paleomagnetic secular variation which can be used as a powerful dating tool. We present the first paleosecular variation record from Lake Geneva (Switzerland) that extends back beyond 16 cal. kyr BP. Several cores up to 10 m long were collected in the delta area of the Promentouse and Asse rivers, close to the city of Nyon. Whole-core declination and horizontal intensity component of the natural remanent magnetization (NRM) were first measured in two cores retrieved from an area without slumps about 1050 and 1400 m from the coast, respectively. In addition, individual samples were extracted from the longest core for further detailed analysis. These samples are characterized by one single NRM component which is stable up to 20 mT. No secondary components (low-stability) have been recognized. As demonstrated by component analysis of IRM acquisition curves, fine-grained magnetite of biogenic origin is the dominant magnetic carrier with additional small amounts of detrital hematite. The declination values obtained from these subsamples display well-defined oscillations within a range of ± 44°. Thirteen major paleosecular declination swings can be distinguished. The inclination curve varies between 30° and 70° and is characterized by a more complex structure. However, nine pronounced features can be recognized. NRM intensity and initial susceptibility correlate well with the stratigraphy showing different trends for the Holocene and the Late Glacial periods. The inclination and declination variations are in excellent agreement with the records from Lac du Joux (Creer et al., 1980) and Lake Windermere (Turner &Thompson, 1981). The paleosecular variation curve of Lake Geneva, combined with lithostratigraphic features, pollen counting analyses and C14 dating, provides a well dated high quality reference curve for central Europe. References Creer, K.M., Hogg, T.E., Readman, P.W. &Reynaud, C. (1980) Palaeomagnetic

  18. [Sculptor of The Cripple of the Geneva Museum of Art and History. An ancient Greek portrayal of hemimelia?].

    PubMed

    Dasen, V

    1997-01-01

    An archaic Greek terracotta vase in the Art and History Museum at Geneva depicts a man deprived of his left arm and with two legs ending in a stump below the knees. Did he suffer from a traumatism (amputation), a mutilating disease or congenital malformation (hemimelia)? A survey of written and iconographic sources throws light on the methods and limits of ancient surgery, and on the chances of survival of abnormal children in archaic and classical Greece.

  19. Reaching Consensus by Allowing Moments of Indecision

    NASA Astrophysics Data System (ADS)

    Svenkeson, A.; Swami, A.

    2015-10-01

    Group decision-making processes often turn into a drawn out and costly battle between two opposing subgroups. Using analytical arguments based on a master equation description of the opinion dynamics occurring in a three-state model of cooperatively interacting units, we show how the capability of a social group to reach consensus can be enhanced when there is an intermediate state for indecisive individuals to pass through. The time spent in the intermediate state must be relatively short compared to that of the two polar states in order to create the beneficial effect. Furthermore, the cooperation between individuals must not be too low, as the benefit to consensus is possible only when the cooperation level exceeds a specific threshold. We also discuss how zealots, agents that remain in one state forever, can affect the consensus among the rest of the population by counteracting the benefit of the intermediate state or making it virtually impossible for an opposition to form.

  20. Reaching Consensus by Allowing Moments of Indecision

    PubMed Central

    Svenkeson, A.; Swami, A.

    2015-01-01

    Group decision-making processes often turn into a drawn out and costly battle between two opposing subgroups. Using analytical arguments based on a master equation description of the opinion dynamics occurring in a three-state model of cooperatively interacting units, we show how the capability of a social group to reach consensus can be enhanced when there is an intermediate state for indecisive individuals to pass through. The time spent in the intermediate state must be relatively short compared to that of the two polar states in order to create the beneficial effect. Furthermore, the cooperation between individuals must not be too low, as the benefit to consensus is possible only when the cooperation level exceeds a specific threshold. We also discuss how zealots, agents that remain in one state forever, can affect the consensus among the rest of the population by counteracting the benefit of the intermediate state or making it virtually impossible for an opposition to form. PMID:26439503

  1. International Society of Urological Pathology (ISUP) grading of prostate cancer - An ISUP consensus on contemporary grading.

    PubMed

    Egevad, Lars; Delahunt, Brett; Srigley, John R; Samaratunga, Hemamali

    2016-06-01

    The International Society of Urological Pathology (ISUP) has issued guidelines for the grading of prostate cancer based on a consensus conference held in 2014. The recommendations resulting from the 2014 consensus conference were a further development of 2005 ISUP modified Gleason grading. In the 2014 system, morphological criteria are clarified, including updated definitions of Gleason pattern 4. In addition to the continued reporting of Gleason scores, we also recommend that Gleason scores ≤6, 3 + 4 = 7, 4 + 3 = 7, 8 and 9-10, respectively, be reported as five groups, i.e. ISUP grades 1-5. This new grading system has the dual benefit of predicting patient outcome as well as facilitating patient communication.

  2. Recommendations for pathology peer review.

    PubMed

    Morton, Daniel; Sellers, Rani S; Barale-Thomas, Erio; Bolon, Brad; George, Catherine; Hardisty, Jerry F; Irizarry, Armando; McKay, Jennifer S; Odin, Marielle; Teranishi, Munehiro

    2010-12-01

    Pathology peer review verifies and improves the accuracy and quality of pathology diagnoses and interpretations. Pathology peer review is recommended when important risk assessment or business decisions are based on nonclinical studies. For pathology peer review conducted before study completion, the peer-review pathologist reviews sufficient slides and pathology data to assist the study pathologist in refining pathology diagnoses and interpretations. Materials to be reviewed are selected by the peer-review pathologist. Consultations with additional experts or a formal (documented) pathology working group may be used to resolve discrepancies. The study pathologist is solely responsible for the content of the final pathology data and report, makes changes resulting from peer-review discussions, initiates the audit trail for microscopic observations after all changes resulting from peer-review have been made, and signs the final pathologist's report. The peer-review pathologist creates a signed peer-review memo describing the peer-review process and confirming that the study pathologist's report accurately and appropriately reflects the pathology data. The study pathologist also may sign a statement of consensus. It is not necessary to archive working notes created during the peer-review process.

  3. Recommendations for Real-Time Speech MRI

    PubMed Central

    Lingala, Sajan Goud; Sutton, Brad P.; Miquel, Marc E.; Nayak, Krishna S.

    2016-01-01

    Real-time magnetic resonance imaging (RT-MRI) is being increasingly used for speech and vocal production research studies. Several imaging protocols have emerged based on advances in RT-MRI acquisition, reconstruction, and audio-processing methods. This review summarizes the state-of-the-art, discusses technical considerations, and provides specific guidance for new groups entering this field. We provide recommendations for performing RT-MRI of the upper airway. This is a consensus statement stemming from the ISMRM-endorsed Speech MRI summit held in Los Angeles, February 2014. A major unmet need identified at the summit was the need for consensus on protocols that can be easily adapted by researchers equipped with conventional MRI systems. To this end, we provide a discussion of tradeoffs in RT-MRI in terms of acquisition requirements, a priori assumptions, artifacts, computational load, and performance for different speech tasks. We provide four recommended protocols and identify appropriate acquisition and reconstruction tools. We list pointers to open-source software that facilitate implementation. We conclude by discussing current open challenges in the methodological aspects of RT-MRI of speech. PMID:26174802

  4. 2nd ESMO Consensus Conference in Lung Cancer: locally advanced stage III non-small-cell lung cancer.

    PubMed

    Eberhardt, W E E; De Ruysscher, D; Weder, W; Le Péchoux, C; De Leyn, P; Hoffmann, H; Westeel, V; Stahel, R; Felip, E; Peters, S

    2015-08-01

    To complement the existing treatment guidelines for all tumour types, ESMO organises consensus conferences to focus on specific issues in each type of tumour. The 2nd ESMO Consensus Conference on Lung Cancer was held on 11-12 May 2013 in Lugano. A total of 35 experts met to address several questions on non-small-cell lung cancer (NSCLC) in each of four areas: pathology and molecular biomarkers, first-line/second and further lines of treatment in advanced disease, early-stage disease and locally advanced disease. For each question, recommendations were made including reference to the grade of recommendation and level of evidence. This consensus paper focuses on locally advanced disease.

  5. Consensus Conference on Brain Tumor Definition for registration. November 10, 2000.

    PubMed Central

    McCarthy, Bridget J.; Surawicz, Tanya; Bruner, Janet M.; Kruchko, Carol; Davis, Faith

    2002-01-01

    The Consensus Conference on Brain Tumor Definition was facilitated by the Central Brain Tumor Registry of the United States and held on November 10, 2000, in Chicago, Illinois, to reach multidisciplinary agreement on a standard definition of brain tumors for collecting and comparing data in the U.S. The Brain Tumor Working Group, convened in 1998 to determine the status of brain tumor collection in the U.S., outlined 4 recommendations of which the first 2 guided the discussion for the Consensus Conference: (1) standardization of a definition of primary brain tumors that is based on site alone, rather than on site and behavior, and that can be used by surveillance organizations in collecting these tumors; and (2) development of a reporting scheme that can be used for comparing estimates of primary brain tumors across registries. Consensus was reached on the collection of all primary brain tumor histologies found and reported in the brain or CNS ICD-O site codes (C70.0-C72.9 and C75.1-C75.3), including those coded benign and uncertain as well as those coded malignant. In addition, a comprehensive listing of histologies occurring in the brain and CNS, based on the CBTRUS grouping scheme, was formulated to provide a template for reporting in accordance with the second recommendation of the Brain Tumor Working Group. With consensus achieved on the first 2 recommendations, the stage is set to move forward in estimating additional resources necessary for the collection of these tumors, including funding, training for cancer registrars, identifying quality control measures, and developing computerized edit checks, as outlined in the last 2 recommendations of the Brain Tumor Working Group. PMID:11916506

  6. The American College of Hyperbaric Medicine consensus statement on physician credentialing for hyperbaric oxygen therapy.

    PubMed

    Serena, Thomas E; Gelly, Helen; Bohn, Gregory A; Niezgoda, Jeffrey A

    2014-08-01

    The American College of Hyperbaric Medicine provides this document for hospital credentialing committees as national standards for credentialing hyperbaric physicians. These recommendations represent the consensus opinion of expert leaders in the field of hyperbaric medicine. The principles set forth in this document are intended to serve as a guideline to assist healthcare organizations. This document applies to both hospital-based and nonhospital-affiliated centers.

  7. Pharmacological management of chronic neuropathic pain: Revised consensus statement from the Canadian Pain Society

    PubMed Central

    Moulin, DE; Boulanger, A; Clark, AJ; Clarke, H; Dao, T; Finley, GA; Furlan, A; Gilron, I; Gordon, A; Morley-Forster, PK; Sessle, BJ; Squire, P; Stinson, J; Taenzer, P; Velly, A; Ware, MA; Weinberg, EL; Williamson, OD

    2014-01-01

    BACKGROUND: Neuropathic pain (NeP), redefined as pain caused by a lesion or a disease of the somatosensory system, is a disabling condition that affects approximately two million Canadians. OBJECTIVE: To review the randomized controlled trials (RCTs) and systematic reviews related to the pharmacological management of NeP to develop a revised evidence-based consensus statement on its management. METHODS: RCTs, systematic reviews and existing guidelines on the pharmacological management of NeP were evaluated at a consensus meeting in May 2012 and updated until September 2013. Medications were recommended in the consensus statement if their analgesic efficacy was supported by at least one methodologically sound RCT (class I or class II) showing significant benefit relative to placebo or another relevant control group. Recommendations for treatment were based on the degree of evidence of analgesic efficacy, safety and ease of use. RESULTS: Analgesic agents recommended for first-line treatments are gabapentinoids (gabapentin and pregabalin), tricyclic antidepressants and serotonin noradrenaline reuptake inhibitors. Tramadol and controlled-release opioid analgesics are recommended as second-line treatments for moderate to severe pain. Cannabinoids are now recommended as third-line treatments. Recommended fourth-line treatments include methadone, anticonvulsants with lesser evidence of efficacy (eg, lamotrigine, lacos-amide), tapentadol and botulinum toxin. There is support for some analgesic combinations in selected NeP conditions. CONCLUSIONS: These guidelines provide an updated, stepwise approach to the pharmacological management of NeP. Treatment should be individualized for each patient based on efficacy, side-effect profile and drug accessibility, including cost. Additional studies are required to examine head-to-head comparisons among analgesics, combinations of analgesics, long-term outcomes and treatment of pediatric, geriatric and central NeP. PMID:25479151

  8. Characteristics of multidrug-resistant Acinetobacter baumannii strains isolated in Geneva during colonization or infection.

    PubMed

    Cherkaoui, Abdessalam; Emonet, Stéphane; Renzi, Gesuele; Schrenzel, Jacques

    2015-09-11

    This study determined the antibiotic susceptibility profile and genetic mechanisms of β-lactam resistance in 27 clinical strains of Acinetobacter baumannii isolated at the University Hospitals of Geneva, Switzerland. The antimicrobial susceptibility testing was performed using Etest and the disc diffusion method in accordance with CLSI guidelines. All of the strains were defined as multi-drug resistant (MDR) and were susceptible to colistin and moderately susceptible to tigecycline. Uniplex PCR assays were used to detect the following β-lactamase genes: four class D carbapenem-hydrolysing oxacillinases (blaOXA-51, blaOXA-23, blaOXA-24 and blaOXA-58), four class B metallo-β-lactamases genes (blaIMP, blaVIM, blaSPM and blaNDM) and two class A carbapenemases (blaKPC and blaGES). All of the strains were positive for blaOXA-51 (intrinsic resistance), 14/27 strains carried blaOXA-23, 2/27 strains carried a blaOXA-24-like gene, and 4/27 strains had a blaOXA-58 gene. blaGES-11 was found in three strains, and NDM-1-harbouring strains were identified in three patients. All of the A. baumannii isolates were typed by rep-PCR (DiversiLab) and excluded any clonality. Altogether, this analysis suggests a very high genetic diversity of imported MDR A. baumannii.

  9. Background, Structure and Priorities of the 2013 Geneva Declaration on Person-centered Health Research.

    PubMed

    Salvador-Carulla, Luis; Cloninger, C Robert; Thornicroft, Amalia; Mezzich, Juan E

    Declarations are relevant tools to frame new areas in health care, to raise awareness and to facilitate knowledge-to-action. The International College on Person Centered Medicine (ICPCM) is seeking to extend the impact of the ICPCM Conference Series by producing a declaration on every main topic. The aim of this paper is to describe the development of the 2013 Geneva Declaration on Person-centered Health Research and to provide additional information on the research priority areas identified during this iterative process. There is a need for more PCM research and for the incorporation of the PCM approach into general health research. Main areas of research focus include: Conceptual, terminological, and ontological issues; research to enhance the empirical evidence of PCM main components such as PCM informed clinical communication; PCM-based diagnostic models; person-centered care and interventions; and people-centered care, research on training and curriculum development. Dissemination and implementation of PCM knowledge-base is integral to Person-centered Health Research and shall engage currently available scientific and translational dissemination tools such journals, events and eHealth.

  10. Introducing the Geneva emotion recognition test: an example of Rasch-based test development.

    PubMed

    Schlegel, Katja; Grandjean, Didier; Scherer, Klaus R

    2014-06-01

    Existing tests to measure the ability to recognize other people's emotional expressions (emotion recognition ability [ERA]) mostly focus on a single modality (usually the face) and include only a small number of emotions, restricting their ecological validity. Further, their reliability is often unsatisfactory. The goal of the present study was to develop a new ERA test (Geneva Emotion Recognition Test [GERT]) that (a) features dynamic and multimodal actor portrayals (short videos with sound), (b) contains a large number of emotions, and (c) is based on modern psychometric principles (item response theory). We asked 295 participants to watch 108 actor portrayals and to choose, for each portrayal, which of 14 emotions had been expressed by the actor. We then applied the Rasch model independently to each of the 14 emotion portrayal subsets to select 83 final items for the GERT. Results showed that the model fits the emotion subtests and the overall GERT and that measurement precision is satisfactory. Consistent with previous findings, we found a decline in ERA with increasing age and an ERA advantage for women. To conclude, the GERT is a promising instrument to measure ERA in a more ecologically valid and comprehensive fashion than previous tests.

  11. Dynamics of auto- and heterotrophic picoplankton and associated viruses in Lake Geneva

    NASA Astrophysics Data System (ADS)

    Parvathi, A.; Zhong, X.; Pradeep Ram, A. S.; Jacquet, S.

    2014-03-01

    Microbial dynamics have rarely been investigated in Lake Geneva, known as the largest lake in western Europe. From a 5-month survey, we report dynamic patterns of free-living virus, bacteria and small phytoplankton abundances in response to a variety of environmental parameters. For the first time, we fractionated the primary production to separate the contribution of different size-related biological compartments and measured both bacterial and viral production in addition to experiments conducted to quantify the virus-induced bacterial mortality. We observed marked seasonal and vertical variations in picocyanobacteria, bacteria and virus abundances and production. The contribution of picoplankton and nanoplankton production to the total primary production was high (reaching up to 76% of total primary production) in November and the spring-summer transition period, respectively. The impact of viral lysis on both bacteria and picocyanobacteria was significantly higher than grazing activities. Virus-induced picocyanobacterial mortality reached up to 66% of cell removal compared to virus induced (heterotrophic) bacterial mortality, which reached a maximum of 34% in July. Statistical analyzes revealed that temperature and top-down control by viruses are among important factors regulating the picocyanobacterial dynamics in this lake. More generally speaking, our results add to the growing evidence and accepted view nowadays that viruses are an important actor of freshwater microbial dynamics and more globally of the functioning of the microbial food webs.

  12. Unusual mortality pattern among short term workers in the perfumery industry in Geneva.

    PubMed Central

    Gubéran, E; Usel, M

    1987-01-01

    A cohort of 537 workers employed for less than one year between 1900 and 1964 in the Geneva perfumery industry was followed up from entry to the end of 1983. During the period of study, 251 workers died and 41 (8%) were lost to follow up. The standardised mortality ratio (SMR) was significantly above 100 for all causes (SMR = 120), all cancers (SMR = 127), lung cancer (SMR = 186), and violent death (SMR = 179). The highest SMR from all causes was associated with the shortest period of employment (less than two months) and it decreased significantly with longer duration. Such mortality excesses had not been recorded among the 1168 workers of the same industry employed one year or more, previously studied in similar fashion. Interviews among a random sample of 52 workers employed for less than two months seem to indicate that the prevalence of smoking, exposures to asbestos, and occupational accidents in other hazardous industries were higher for these workers than for the reference population. Furthermore, unmarried men were overrepresented among the study cohort. These findings support previous observations indicating that short term workers share atypical features related to high mortality from various causes. It is suggested that mortality in this subgroup should be analysed separately in occupational studies. PMID:3663526

  13. Typology of injection profiles of clients of a supervised drug consumption facility in Geneva, Switzerland.

    PubMed

    Dubois-Arber, Françoise; Benninghoff, Fabienne; Jeannin, André

    2008-01-01

    The use of a supervised drug consumption room (DCR) in a newly established low threshold facility in Geneva, Switzerland, in 2002 is analyzed. Two sources of routine data were used: data collected at the first visit by any new client (entry questionnaire) which included some personal details, and data collected on the substances injected at each visit to the DCR. A typology of injection profiles was constructed. Overall, the mean number of injections and days of visits per client over the year was low and cocaine was the main substance injected. However, an important heterogeneity in the use of the DCR was found and five types of clients identified: 1-day clients; standard clients; heroin-oriented clients; high cocaine consumption clients, and newcomers. Typology was associated with some characteristics at the first visit and the drug consumption pattern in the month preceding the first visit was in accordance with the subsequent use of the DCR. This heterogeneity in the use of the DCR highlights the diverse roles of the DCRs in harm reduction.

  14. Sexual and reproductive health behaviors of undocumented migrants in Geneva: a cross sectional study.

    PubMed

    Sebo, Paul; Jackson, Yves; Haller, Dagmar M; Gaspoz, Jean-Michel; Wolff, Hans

    2011-06-01

    Undocumented migrants face major barriers in accessing prevention and health care. Whereas the association between low socioeconomic status and poor health is well documented only few studies have addressed specific health issues in undocumented migrants. The aim of the present study is to describe sexual and reproductive health behaviors of undocumented migrants in Geneva. This descriptive cross sectional study included consecutive undocumented migrants presenting from November 2007 to February 2008 to a health facility offering free access to health care to this population. Following informed consent, they completed a self administered questionnaire about their socio-demographic profile and sexual and reproductive health behaviors. A total of 384 patients were eligible for the study. 313 (82%) agreed to participate of which 77% (241 patients) completed the survey. Participants were mainly young, Latino-American, single, well-educated and currently working women. They had multiple partners and reported frequently engaging in sexual intercourse. Use of contraceptive methods and strategies of prevention against sexually transmitted infections (STI) were rare. Nearly half of the women had had at least one induced abortion and 40% had had an unplanned pregnancy. One in four participants reported a current or past STI or other genital infection. The results of our study suggest that undocumented migrants engage in frequent and high risk sexual intercourse with insufficient use of contraceptive methods and suboptimal strategies of prevention against STI. Our study underlines the real need for specific sexual and reproductive educational programs targeting this hard to reach population.

  15. Improving the Spiritual Dimension of Whole Person Care: Reaching National and International Consensus

    PubMed Central

    Vitillo, Robert; Hull, Sharon K.; Reller, Nancy

    2014-01-01

    Abstract Two conferences, Creating More Compassionate Systems of Care (November 2012) and On Improving the Spiritual Dimension of Whole Person Care: The Transformational Role of Compassion, Love and Forgiveness in Health Care (January 2013), were convened with the goals of reaching consensus on approaches to the integration of spirituality into health care structures at all levels and development of strategies to create more compassionate systems of care. The conferences built on the work of a 2009 consensus conference, Improving the Quality of Spiritual Care as a Dimension of Palliative Care. Conference organizers in 2012 and 2013 aimed to identify consensus-derived care standards and recommendations for implementing them by building and expanding on the 2009 conference model of interprofessional spiritual care and its recommendations for palliative care. The 2013 conference built on the 2012 conference to produce a set of standards and recommended strategies for integrating spiritual care across the entire health care continuum, not just palliative care. Deliberations were based on evidence that spiritual care is a fundamental component of high-quality compassionate health care and it is most effective when it is recognized and reflected in the attitudes and actions of both patients and health care providers. PMID:24842136

  16. The Society for Immunotherapy of Cancer consensus statement on immunotherapy for the treatment of prostate carcinoma.

    PubMed

    McNeel, Douglas G; Bander, Neil H; Beer, Tomasz M; Drake, Charles G; Fong, Lawrence; Harrelson, Stacey; Kantoff, Philip W; Madan, Ravi A; Oh, William K; Peace, David J; Petrylak, Daniel P; Porterfield, Hank; Sartor, Oliver; Shore, Neal D; Slovin, Susan F; Stein, Mark N; Vieweg, Johannes; Gulley, James L

    2016-01-01

    Prostate cancer is the most commonly diagnosed malignancy and second leading cause of cancer death among men in the United States. In recent years, several new agents, including cancer immunotherapies, have been approved or are currently being investigated in late-stage clinical trials for the management of advanced prostate cancer. Therefore, the Society for Immunotherapy of Cancer (SITC) convened a multidisciplinary panel, including physicians, nurses, and patient advocates, to develop consensus recommendations for the clinical application of immunotherapy for prostate cancer patients. To do so, a systematic literature search was performed to identify high-impact papers from 2006 until 2014 and was further supplemented with literature provided by the panel. Results from the consensus panel voting and discussion as well as the literature review were used to rate supporting evidence and generate recommendations for the use of immunotherapy in prostate cancer patients. Sipuleucel-T, an autologous dendritic cell vaccine, is the first and currently only immunotherapeutic agent approved for the clinical management of metastatic castrate resistant prostate cancer (mCRPC). The consensus panel utilized this model to discuss immunotherapy in the treatment of prostate cancer, issues related to patient selection, monitoring of patients during and post treatment, and sequence/combination with other anti-cancer treatments. Potential immunotherapies emerging from late-stage clinical trials are also discussed. As immunotherapy evolves as a therapeutic option for the treatment of prostate cancer, these recommendations will be updated accordingly.

  17. Multidisciplinary management of hepatocellular carcinoma with portal vein tumor thrombus - Eastern Hepatobiliary Surgical Hospital consensus statement.

    PubMed

    Cheng, Shuqun; Yang, Jiamei; Shen, Feng; Zhou, Weiping; Wang, Yi; Cong, Wenming; Yang, Guang Shun; Cheng, Hongyan; Hu, Heping; Gao, Chunfang; Guo, Jia; Li, Aijun; Meng, Yan; Jiang, Xiaoqing; Yang, Yefa; Qian, Guojun; Luo, Ming; Hu, Bing; Man, Xiaobo; Zhang, Baohua; Su, Changqing; Zhou, Feiguo; Li, Nan; Shi, Jie; Wang, Meng; Zheng, Yaxin; Guo, Weixing; Sun, Juxian; Wang, Hongyang; Lau, Wan-Yee; Wu, Meng-Chao

    2016-06-28

    Hepatocellular carcinoma (HCC) complicated by portal vein tumor thrombus (PVTT) is associated with poor prognosis, early recurrence of HCC, and limited treatment options. Current guidelines do not have standardized diagnostic and treatment modalities, thus creating a need for a multidisciplinary treatment model for standardization of the treatment. Eastern Hepatobiliary Surgical Hospital (China) convened two working parties of experts from all the departments, to consolidate the current evidence, prevailing vision for the future, and experience of the practicing clinicians engaged in HCC management, so as to develop a consensus for PVTT diagnosis and treatment according to the GRADE system. Based on the quality of the existing evidence and the strength of recommendations, the consensus statements were categorized into 3 evidence levels (A/B/C) and 5 classes (I/II/IIa/IIb/III).The panel discussed and provided clarity on the management and research options in the field of HCC with PVTT. In addition, the panel also assessed the quality of the cited studies and assigned grades to the recommendation statements. Among the group of experts, there was excellent agreement with regard to effective diagnosis and treatment of HCC with PVTT. The recommendations of this consensus will provide guidance to physicians and clinical researchers on the effective management of HCC with PVTT.

  18. A consensus conference on management of the lower third molar. Italian Society of Odontostomatological Surgery.

    PubMed

    Annibali, S; De Biase, A; Pippi, R; Sfasciotti, G L

    2011-10-01

    During the first Congress of the Italian University Schools of Oral Surgery, held in Rome on 18-20th February, 2010, a task force was convened by the Italian Society of Odontostomatological Surgery (SIdCO) to summarize the data collected from the current literature on selected aspects relating to the mandibular third molar and its removal. The task of the Conference Participants was to review and analyze the pertinent literature and to elaborate conclusive recommendations for the management of the lower third molar. The statements made and the recommendations presented represent the consensus of the Conference, which can be considered the official statement of the SIdCO.

  19. [Modern surgical treatment of breast cancer. 3rd Breast Cancer Consensus Conference].

    PubMed

    Lázár, György; Bursics, Attila; Farsang, Zoltán; Harsányi, László; Kósa, Csaba; Maráz, Róbert; Mátrai, Zoltán; Paszt, Attila; Pavlovics, Gábor; Tamás, Róbert

    2016-09-01

    Therapy for breast cancer today is characterised by ever more precise diagnostic methods and ever more effective oncological treatments, a trend which will certainly continue into the future. Breast preservation and the application of oncoplastic principles are increasingly popular. A sentinel lymph node biopsy in the surgical treatment of the axilla is primary, with the indication for axillary block dissection (ABD) narrowing and radiation therapy becoming an alternative to ABD in certain cases. This publication summarises our recommendations on the surgical treatment of breast cancer based on the content of the 3rd Breast Cancer Consensus Conference and considering the latest international studies and professional recommendations.

  20. Photopatch testing: a consensus methodology for Europe.

    PubMed

    Bruynzeel, D P; Ferguson, J; Andersen, K; Gonçalo, M; English, John; Goossens, A; Holzle, E; Ibbotson, S H; Lecha, M; Lehmann, P; Leonard, F; Moseley, Harry; Pigatto, P; Tanew, A

    2004-11-01

    A group of interested European Contact Dermatologists/Photobiologists met to produce a consensus statement on methodology, test materials and interpretation of photopatch testing. While it is recognized that a range of local variables operate throughout Europe, the underlying purpose of the work is to act as an essential preamble to a Pan European Photopatch Test Study focusing particularly on sunscreen chemicals.

  1. Epistemic Iterations and Consensus Definitions of Validity

    ERIC Educational Resources Information Center

    Engelhard, George, Jr.; Behizadeh, Nadia

    2012-01-01

    In his article, Paul E. Newton has conducted a review of selected perspectives on validity theory with the goal of disambiguating the definition of validity and describing a consensus definition of validity. Newton provides a nuanced discussion of the evolution of the concept of validity over the years. His Focus article has two major goals: (1)…

  2. Consensus among Economists--An Update

    ERIC Educational Resources Information Center

    Fuller, Dan; Geide-Stevenson, Doris

    2014-01-01

    In this article, the authors explore consensus among economists on specific propositions based on a fall 2011 survey of American Economic Association members. Results are based on 568 responses and provide evidence of changes in opinion over time by including propositions from earlier studies in 2000 (Fuller and Geide-Stevenson 2003) and 1992…

  3. Health Promoting Schools: Consensus, Strategies, and Potential

    ERIC Educational Resources Information Center

    Macnab, Andrew J.; Gagnon, Faith A.; Stewart, Donald

    2014-01-01

    Purpose: The purpose of this paper is to summarize a consensus statement generated on the current challenges, strategies, and potential of health promoting schools (HPS) at a 2011 colloquium at the Stellenbosch Institute for Advanced Study where 40 people from five continents came together to share their global and regional experience surrounding…

  4. Adaptive bipartite consensus on coopetition networks

    NASA Astrophysics Data System (ADS)

    Hu, Jiangping; Zhu, Hong

    2015-07-01

    In this paper, a bipartite consensus tracking problem is considered for a group of autonomous agents on a coopetition network, on which the agents interact cooperatively and competitively simultaneously. The coopetition network involves positive and negative edges and is conveniently modeled by a signed graph. Additionally, the dynamics of all the agents are subjected to unknown disturbances, which are represented by linearly parameterized models. An adaptive estimation scheme is designed for each agent by virtue of the relative position measurements and the relative velocity measurements from its neighbors. Then a consensus tracking law is proposed for a new distributed system, which uses the relative measurements as the new state variables. The convergence of the consensus tracking error and the parameter estimation are analyzed even when the coopetition network is time-varying and no more global information about the bounds of the unknown disturbances is available to all the agents. Finally, some simulation results are provided to demonstrate the formation of the bipartite consensus on the coopetition network.

  5. Consensus among Economics Teachers from Transition Economies

    ERIC Educational Resources Information Center

    Leet, Don R.; Lang, Nancy A.

    2010-01-01

    The authors analyze the economic opinions of teachers and economists from the former Soviet Union who participated in economic education programs sponsored by the U.S. Department of Education under the auspices of the National Council on Economic Education from 1995-2001. They sought to determine the level of consensus on economic topics among the…

  6. Statistical Inference for Cultural Consensus Theory

    DTIC Science & Technology

    2014-02-24

    Facts on Aging Quiz ”. Covariates were also incorporated into the model, and it was shown that a consensus answer key that corresponded to the...Structural balance: a generalization of Heider’s theory. Psychological Review, 63, 277-293. Palmore, E. (1998). Facts on aging quiz , second edition

  7. The Overreliance of Accreditors on Consensus Standards.

    ERIC Educational Resources Information Center

    Murray, Frank B.

    2001-01-01

    Argues that the legitimacy of accreditation in teacher education is rooted in political consensus, power, and scholarship. Because these roots are fragile, there is no accepted concept of educational malpractice. The legitimacy of accreditation should be rooted in scholarly evidence that the program has fulfilled the claim that its graduates are…

  8. Report of the Consensus Planning Project.

    ERIC Educational Resources Information Center

    Council of Chief State School Officers, Washington, DC.

    This third report of the National Assessment Planning Project concentrates on the consensus planning process used in the project. The project is an outgrowth of National Assessment of Educational Progress (NAEP) program expansion, whose original task was to produce state-by-state comparisons of student achievement. The report is organized in four…

  9. Quorum responses and consensus decision making

    PubMed Central

    Sumpter, David J.T.; Pratt, Stephen C.

    2008-01-01

    Animal groups are said to make consensus decisions when group members come to agree on the same option. Consensus decisions are taxonomically widespread and potentially offer three key benefits: maintenance of group cohesion, enhancement of decision accuracy compared with lone individuals and improvement in decision speed. In the absence of centralized control, arriving at a consensus depends on local interactions in which each individual's likelihood of choosing an option increases with the number of others already committed to that option. The resulting positive feedback can effectively direct most or all group members to the best available choice. In this paper, we examine the functional form of the individual response to others' behaviour that lies at the heart of this process. We review recent theoretical and empirical work on consensus decisions, and we develop a simple mathematical model to show the central importance to speedy and accurate decisions of quorum responses, in which an animal's probability of exhibiting a behaviour is a sharply nonlinear function of the number of other individuals already performing this behaviour. We argue that systems relying on such quorum rules can achieve cohesive choice of the best option while also permitting adaptive tuning of the trade-off between decision speed and accuracy. PMID:19073480

  10. Report on the consensus workshop on formaldehyde

    SciTech Connect

    Gough, M.; Hart, R.; Karrh, B.W.; Koestner, A.; Neal, R.; Parkinson, D.; Perera, F.; Powell, K.E.; Rosenkranz, S.

    1984-01-01

    The Consensus Workshop on Formaldehyde consisted of bringing together scientists from academia, government, industry and public interest groups to address some important toxicological questions concerning the health effects of formaldehyde. The participants in the workshop, the Executive Panel which coordinated the meeting, and the questions posed, all were chosen through a broadly based nomination process in order to achieve as comprehensive a consensus as possible. The subcommittees considered the toxicological problems associated with formaldehyde in the areas of exposure, epidemiology, carcinogenicity/histology/genotoxicity, immunology/sensitization/irritation, structure activity/biochemistry metabolism, reproduction/teratology, behavior/neurotoxicity/psychology and risk estimation. Some questions considered included the possible human carcinogenicity of formaldehyde, as well as other human health effects, and the interpretation of pathology induced by formaldehyde. These reports, plus introductory material on the procedures used in setting up the Consensus Workshop are presented here. Additionally, there is included a listing of the data base that was made available to the panel chairmen prior to the meeting and was readily accessible to the participants during their deliberations in the meeting. This data base, since it was computerized, was also capable of being searched for important terms. These materials were supplemented by information brought by the panelists. The workshop has defined the consensus concerning a number of major points in formaldehyde toxicology and has identified a number of major deficits in understanding which are important guides to future research. 264 references.

  11. Report on the Consensus Workshop on Formaldehyde.

    PubMed Central

    1984-01-01

    The Consensus Workshop on Formaldehyde consisted of bringing together scientists from academia, government, industry and public interest groups to address some important toxicological questions concerning the health effects of formaldehyde. The participants in the workshop, the Executive Panel which coordinated the meeting, and the questions posed, all were chosen through a broadly based nomination process in order to achieve as comprehensive a consensus as possible. The subcommittees considered the toxicological problems associated with formaldehyde in the areas of exposure, epidemiology, carcinogenicity/histology/genotoxicity, immunology/sensitization/irritation, structure activity/biochemistry/metabolism, reproduction/teratology, behavior/neurotoxicity/psychology and risk estimation. Some questions considered included the possible human carcinogenicity of formaldehyde, as well as other human health effects, and the interpretation of pathology induced by formaldehyde. These reports, plus introductory material on the procedures used in setting up the Consensus Workshop are presented here. Additionally, there is included a listing of the data base that was made available to the panel chairmen prior to the meeting and was readily accessible to the participants during their deliberations in the meeting. This data base, since it was computerized, was also capable of being searched for important terms. These materials were supplemented by information brought by the panelists. The workshop has defined the consensus concerning a number of major points in formaldehyde toxicology and has identified a number of major deficits in understanding which are important guides to future research. PMID:6525992

  12. Research to Practice: Implementing Physical Activity Recommendations

    PubMed Central

    Davis, Sally M.; Cruz, Theresa H.; Kozoll, Richard

    2016-01-01

    Introduction Dissemination and implementation (D&I) science focuses on bridging the gap between research and practice. The Community Preventive Services Task Force (CPSTF) published recommendations for increasing physical activity based on scientific review and consensus. Little research on the D&I of these recommendations has been conducted in under-represented populations at high risk for inactivity and chronic disease. Methods Partnering with one rural community (beta site), the University of New Mexico Prevention Research Center studied the translation of CPSTF recommendations to practice. Strategies for increasing physical activity were selected, implemented, and analyzed in 2009 to 2013. Participant observations; content analysis of meeting minutes, field notes, and other documents; and in-depth interviews were conducted over the 5-year period to identify factors important for carrying out the CPSTF recommendations for physical activity in a rural New Mexico community. Results Included among the implementation outcomes were new sidewalks and trails, a community-wide campaign, social support of walking, and park improvements. The following factors were identified as important to the implementation process: an active community-academic partnership; multiple partners; culturally appropriate strategies; and approaches that fit local context and place characteristics (topography, land ownership, population clusters, existing roadways). Conclusions This study illustrates how evidence can be translated to practice and identifies key factors in that process. The successful beta model provides a practical blueprint for D&I in rural, under-represented populations. This model is currently being disseminated (scaled up) to other rural New Mexico communities. PMID:28215385

  13. [Early viscoelasticity-based coagulation therapy for severely injured bleeding patients: Report of the consensus group on the consensus conference 2014 for formulation of S2k guidelines].

    PubMed

    Maegele, M; Inaba, K; Rizoli, S; Veigas, P; Callum, J; Davenport, R; Fröhlich, M; Hess, J

    2015-10-01

    Although there is increasing interest in the use of a viscoelastic test procedure (ROTEM/TEG) for diagnostics and therapy guidance of severely injured and bleeding patients, currently no uniformly accepted guidelines exist for how this technology should be integrated into clinical treatment. In September 2014 an international multidisciplinary group of opinion leaders in the field of trauma-induced coagulopathy and other disciplines involved in the treatment of severely injured patients were assembled for a 2-day consensus conference in Philadelphia (USA). This panel included trauma/accident surgeons, general/abdominal surgeons, vascular surgeons, emergency/intensive care surgeons, hematologists, transfusion specialists, anesthesiologists, laboratory physicians, pathobiologists/pathophysiologists and the lay public. A total of nine questions regarding the impact of viscoelastic testing in the early treatment of trauma patients were developed prior to the conference by a panel consensus. Early use was defined as baseline viscoelastic test result thresholds obtained within the first minutes of hospital arrival, when conventional laboratory results are not yet available. The available data for each question were then reviewed in person using standardized presentations by the expert panel. A consensus summary document was then developed and reviewed by the panel in an open forum. Finally, a 2-round Delphi poll was administered to the panel of experts regarding viscoelastic thresholds for triggering the initiation of specific treatments including fibrinogen (concentrates), platelet concentrates, blood plasma products and prothrombin complex concentrates (PCC). This report summarizes the findings and recommendations of this consensus conference, which correspond to a S2k guideline according to the system of the Association of the Scientific Medical Societies in Germany (AWMF) and taking formal consensus findings including Delphi methods into consideration.

  14. A consensus statement on lipid management after acute coronary syndrome.

    PubMed

    Schiele, François; Farnier, Michel; Krempf, Michel; Bruckert, Eric; Ferrières, Jean

    2016-11-17

    In patients admitted for acute coronary syndrome (ACS), the guidelines of the European Society of Cardiology give a Class I, Level A recommendation for the prescription of high-intensity statins to be initiated as early as possible, regardless of the low-density lipoprotein cholesterol (LDL-C) level. Although statins are widely prescribed after ACS, the intensity of therapy and the proportion of patients achieving target LDL-C values are often not in line with recommendations due to a lack of compliance with guidelines by the physicians, a lack of compliance with treatment or poor tolerance by patients, and poor dose adaptation. In this context, a group of French physicians came together to define strategies to facilitate and improve the management of lipid-lowering therapy after ACS. This paper outlines the scientific rationale for the use of statins at the acute phase of ACS, the utility of ezetimibe, the measurement of LDL-C during the course of ACS, the opportunities for detecting familial hypercholesterolaemia and the results of the consensus for the management of lipid-lowering therapy, illustrated in two decision-making algorithms.

  15. Expert consensus document: A consensus on the medical treatment of acromegaly.

    PubMed

    Giustina, Andrea; Chanson, Philippe; Kleinberg, David; Bronstein, Marcello D; Clemmons, David R; Klibanski, Anne; van der Lely, Aart J; Strasburger, Christian J; Lamberts, Steven W; Ho, Ken K Y; Casanueva, Felipe F; Melmed, Shlomo

    2014-04-01

    In March 2013, the Acromegaly Consensus Group met to revise and update guidelines for the medical treatment of acromegaly. The meeting comprised experts skilled in the medical management of acromegaly. The group considered treatment goals covering biochemical, clinical and tumour volume outcomes, and the place in guidelines of somatostatin receptor ligands, growth hormone receptor antagonists and dopamine agonists, and alternative modalities for treatment including combination therapy and novel treatments. This document represents the conclusions of the workshop consensus.

  16. Analysis and recommendations for DPA calculations in SiC

    SciTech Connect

    Heinisch, H.L.

    1998-09-01

    Recent modeling results, coupled with the implications of available experimental results, provide sufficient information to achieve consensus on the values of threshold displacement energies to use in displacements per atom (DPA) calculations. The values recommended here, 20 eV for C and 35 eV for Si, will be presented for adoption by the international fusion materials community at the next IEA SiC/SiC workshop.

  17. Towards a 21st century roadmap for biomedical research and drug discovery: Consensus report and recommendations

    EPA Science Inventory

    Decades of costly failures in translating drug candidates from preclinical disease models to human therapeutic use warrant reconsideration of the priority placed on animal models in biomedical research. Following an international workshop attended by experts from academia, govern...

  18. Scientific panel on electromagnetic field health risks: consensus points, recommendations, and rationales.

    PubMed

    Fragopoulou, Adamantia; Grigoriev, Yuri; Johansson, Olle; Margaritis, Lukas H; Morgan, Lloyd; Richter, Elihu; Sage, Cindy

    2010-01-01

    In November, 2009, a scientific panel met in Seletun, Norway, for three days of intensive discussion on existing scientific evidence and public health implications of the unprecedented global exposures to artificial electromagnetic fields (EMF). EMF exposures (static to 300 GHz) result from the use of electric power and from wireless telecommunications technologies for voice and data transmission, energy, security, military and radar use in weather and transportation. The Scientific Panel recognizes that the body of evidence on EMF requires a new approach to protection of public health; the growth and development of the fetus, and of children; and argues for strong preventative actions. New, biologically-based public exposure standards are urgently needed to protect public health worldwide.

  19. Painful diabetic peripheral neuropathy: consensus recommendations on diagnosis, assessment and management.

    PubMed

    Tesfaye, S; Vileikyte, L; Rayman, G; Sindrup, S H; Perkins, B A; Baconja, M; Vinik, A I; Boulton, A J M

    2011-10-01

    Painful diabetic peripheral neuropathy (DPN) is common, is associated with significant reduction in quality of life and poses major treatment challenges to the practising physician. Although poor glucose control and cardiovascular risk factors have been proven to contribute to the aetiology of DPN, risk factors specific for painful DPN remain unknown. A number of instruments have been tested to assess the character, intensity and impact of painful DPN on quality of life, activities of daily living and mood. Management of the patient with DPN must be tailored to individual requirements, taking into consideration the co-morbidities and other factors. Pharmacological agents with proven efficacy for painful DPN include tricyclic anti-depressants, the selective serotonin and noradrenaline re-uptake inhibitors, anti-convulsants, opiates, membrane stabilizers, the anti-oxidant alpha-lipoic acid and topical agents including capsaicin. Current first-line therapies for painful DPN include tricyclic anti-depressants, the serotonin and noradrenaline re-uptake inhibitor duloxetine and the anti-convulsants pregabalin and gabapentin. When prescribing any of these agents, other co-morbidities and costs must be taken into account. Second-line approaches include the use of opiates such as synthetic opioid tramadol, morphine and oxycodone-controlled release. There is a limited literature with regard to combination treatment. In extreme cases of painful DPN unresponsive to pharmacotherapy, occasional use of electrical spinal cord stimulation might be indicated. There are a number of unmet needs in the therapeutic management of painful DPN. These include the need for randomized controlled trials with active comparators and data on the long-term efficacy of agents used, as most trials have lasted for less than 6 months. Finally, there is a need for appropriately designed studies to investigate non-pharmacological approaches.

  20. Consultant outcomes publication and surgical training: Consensus recommendations by the association of surgeons in training.

    PubMed

    Mohan, Helen M; Gokani, Vimal J; Williams, Adam P; Harries, Rhiannon L

    2016-11-01

    Consultant Outcomes Publication (COP) has the longest history in cardiothoracic surgery, where it was introduced in 2005. Subsequently COP has been broadened to include all surgical specialties in NHS England in 2013-14. The Association of Surgeons in Training (ASiT) fully supports efforts to improve patient care and trust in the profession and is keen to overcome potential unintended adverse effects of COP. Identification of these adverse effects is the first step in this process: Firstly, there is a risk that COP may lead to reluctance by consultants to provide trainees with the necessary appropriate primary operator experience to become skilled consultant surgeons for the future. Secondly, COP may lead to inappropriately cautious case selection. This adjusted case mix affects both patients who are denied operations, and also limits the complexity of the case mix to which surgical trainees are exposed. Thirdly, COP undermines efforts to train surgical trainees in non-technical skills and human factors, simply obliterating the critical role of the multidisciplinary team and organisational processes in determining outcomes. This tunnel vision masks opportunities to improve patient care and outcomes at a unit level. It also misinforms the public as to the root causes of adverse events by failing to identify care process deficiencies. Finally, for safe surgical care, graduate retention and morale is important - COP may lead to high calibre trainees opting out of surgical careers, or opting to work abroad. The negative effects of COP on surgical training and trainees must be addressed as high quality surgical training and retention of high calibre graduates is essential for excellent patient care.

  1. Australian recommendations for the management of hepatitis C virus infection: a consensus statement.

    PubMed

    Thompson, Alexander J V

    2016-04-18

    Chronic hepatitis C virus (HCV) infection affects 230 000 Australians, who are at risk of progressive liver fibrosis leading to cirrhosis, liver failure and hepatocellular carcinoma. HCV infection is curable, and all Australians living with HCV should be considered for antiviral therapy. Interferon-free regimens involving combinations of sofosbuvir, ledipasvir, daclatasvir and/or ribavirin for 8, 12 or 24 weeks are now listed on the Pharmaceutical Benefits Scheme (PBS) for treating people with genotypes 1-3 HCV. Treatment for genotypes 4-6 HCV involves sofosbuvir plus peginterferon-alfa and ribavirin for 12 weeks. The PBS listing allows these therapies to be prescribed by specialists experienced in treating chronic HCV infection or by general practitioners in consultation with one of these specialists. People with cirrhosis and other special populations (eg, those with decompensated liver disease or renal impairment) should be referred for specialist care. Key issues during pre-treatment assessment include identifying HCV genotype, evaluating for cirrhosis and considering concomitant medications for risk of drug-drug interactions.

  2. Recommended Minimal Emergency Equipment and Resources for Schools: National Consensus Group Report

    ERIC Educational Resources Information Center

    Bobo, Nichole; Hallenbeck, Paula; Robinson, Judith

    2003-01-01

    Providing an environment that is responsive to emergency health needs of students is essential to creating a safe setting for children in schools. The question of what minimal essential emergency equipment and resources should be available in schools brings with it many and varied opinions, issues, and concerns. Through funding from the Emergency…

  3. The Second International Conference on Indochinese Refugees: A New Humanitarian Consensus?

    ERIC Educational Resources Information Center

    Refugee Policy Group, Washington, DC.

    This paper was written in anticipation of the International Conference on Indochinese Refugees (ICIR), held in June 1989 in Geneva (Switzerland). The ICIR was convened to respond to chronic refugee problems in the region, first addressed in the July 1979 Meeting in Geneva on the Situation of Refugees and Displaced Persons in Southeast Asia. It is…

  4. Identification of Cryptosporidium Species in Fish from Lake Geneva (Lac Léman) in France.

    PubMed

    Certad, Gabriela; Dupouy-Camet, Jean; Gantois, Nausicaa; Hammouma-Ghelboun, Ourida; Pottier, Muriel; Guyot, Karine; Benamrouz, Sadia; Osman, Marwan; Delaire, Baptiste; Creusy, Colette; Viscogliosi, Eric; Dei-Cas, Eduardo; Aliouat-Denis, Cecile Marie; Follet, Jérôme

    2015-01-01

    Cryptosporidium, a protozoan parasite that can cause severe diarrhea in a wide range of vertebrates including humans, is increasingly recognized as a parasite of a diverse range of wildlife species. However, little data are available regarding the identification of Cryptosporidium species and genotypes in wild aquatic environments, and more particularly in edible freshwater fish. To evaluate the prevalence of Cryptosporidiumspp. in fish from Lake Geneva (Lac Léman) in France, 41 entire fish and 100 fillets (cuts of fish flesh) were collected from fishery suppliers around the lake. Nested PCR using degenerate primers followed by sequence analysis was used. Five fish species were identified as potential hosts of Cryptosporidium: Salvelinus alpinus, Esox lucius, Coregonus lavaretus, Perca fluviatilis, and Rutilus rutilus. The presence of Cryptosporidium spp. was found in 15 out of 41 fish (37%), distributed as follows: 13 (87%) C. parvum, 1 (7%) C. molnari, and 1 (7%) mixed infection (C. parvum and C. molnari). C. molnari was identified in the stomach, while C. parvum was found in the stomach and intestine. C. molnari was also detected in 1 out of 100 analyzed fillets. In order to identify Cryptosporidium subtypes, sequencing of the highly polymorphic 60-kDa glycoprotein (gp60) was performed. Among the C. parvum positive samples, three gp60 subtypes were identified: IIaA15G2R1, IIaA16G2R1, and IIaA17G2R1. Histological examination confirmed the presence of potential developmental stages of C. parvum within digestive epithelial cells. These observations suggest that C. parvum is infecting fish, rather than being passively carried. Since C. parvum is a zoonotic species, fish potentially contaminated by the same subtypes found in terrestrial mammals would be an additional source of infection for humans and animals, and may also contribute to the contamination of the environment with this parasite. Moreover, the risk of human transmission is strengthened by the

  5. Modelling past landslide-induced tsunami in Lake Geneva to evaluate the present threat

    NASA Astrophysics Data System (ADS)

    Franz, Martin; Jaboyedoff, Michel; Podladchikov, Yury

    2014-05-01

    In the south-eastern part of Lake Geneva, in the community of Meillerie, France, is located a forested depression, which indicates that a landslide occurred at this place in a distant past. It is a partially submerged slide composed of Trias to Jurassic carbonates. As its volume is greater than 10 mio m3, we assume that a potential brusque failure would have generated an impulse wave able to spread across the lake and reach the location of contemporary cities. Since this type of events is still likely to occur nowadays, this study aims to characterise the tsunami triggered by the past landslide event in order to know the potential wave height in populated places around the lake for events of similar magnitude. The volume of the displaced mass is estimated using the inverse Sloping Local Base Level (SLBL) by subtracting the pre-failure topography (built with the SLBL) to the actual one. In order to model landslide-triggered tsunami, it is necessary to be able to simulate the generation, the propagation of the wave in the lake and on the shores. This task is performed using a two-dimensional numerical model based on the shallow water equations. The Lax-Friedrichs scheme is used for the numerical stabilisation. The preliminary results indicate that the wave propagated across the lake up to distant places. As the shores are today extensively urbanised, in a similar case, they would be subject to catastrophic consequences. Thus, sensitivity tests are conducted for variation of the size and the velocities of the landslide in the model in order to give a distribution of the associated risks.

  6. Identification of Cryptosporidium Species in Fish from Lake Geneva (Lac Léman) in France

    PubMed Central

    Certad, Gabriela; Dupouy-Camet, Jean; Gantois, Nausicaa; Hammouma-Ghelboun, Ourida; Pottier, Muriel; Guyot, Karine; Benamrouz, Sadia; Osman, Marwan; Delaire, Baptiste; Creusy, Colette; Viscogliosi, Eric; Aliouat-Denis, Cecile Marie; Follet, Jérôme

    2015-01-01

    Cryptosporidium, a protozoan parasite that can cause severe diarrhea in a wide range of vertebrates including humans, is increasingly recognized as a parasite of a diverse range of wildlife species. However, little data are available regarding the identification of Cryptosporidium species and genotypes in wild aquatic environments, and more particularly in edible freshwater fish. To evaluate the prevalence of Cryptosporidiumspp. in fish from Lake Geneva (Lac Léman) in France, 41 entire fish and 100 fillets (cuts of fish flesh) were collected from fishery suppliers around the lake. Nested PCR using degenerate primers followed by sequence analysis was used. Five fish species were identified as potential hosts of Cryptosporidium: Salvelinus alpinus, Esox lucius, Coregonus lavaretus, Perca fluviatilis, and Rutilus rutilus. The presence of Cryptosporidium spp. was found in 15 out of 41 fish (37%), distributed as follows: 13 (87%) C. parvum, 1 (7%) C. molnari, and 1 (7%) mixed infection (C. parvum and C. molnari). C. molnari was identified in the stomach, while C. parvum was found in the stomach and intestine. C. molnari was also detected in 1 out of 100 analyzed fillets. In order to identify Cryptosporidium subtypes, sequencing of the highly polymorphic 60-kDa glycoprotein (gp60) was performed. Among the C. parvum positive samples, three gp60 subtypes were identified: IIaA15G2R1, IIaA16G2R1, and IIaA17G2R1. Histological examination confirmed the presence of potential developmental stages of C. parvum within digestive epithelial cells. These observations suggest that C. parvum is infecting fish, rather than being passively carried. Since C. parvum is a zoonotic species, fish potentially contaminated by the same subtypes found in terrestrial mammals would be an additional source of infection for humans and animals, and may also contribute to the contamination of the environment with this parasite. Moreover, the risk of human transmission is strengthened by the

  7. Adaptation and Integration of Permanent Immigrants Seminar (4th, Geneva, Switzerland, May 8-11, 1979).

    ERIC Educational Resources Information Center

    International Migration, 1979

    1979-01-01

    This document contains working papers prepared for a seminar on Adaptation and Integration of Permanent Immigrants, along with general and specific recommendations formulated by seminar participants. Conclusions and recommendations from each paper are presented in English, French, and Spanish; the conference papers themselves are presented only in…

  8. Esophageal cancer screening in achalasia: is there a consensus?

    PubMed

    Ravi, K; Geno, D M; Katzka, D A

    2015-04-01

    Achalasia is an important but relatively uncommon disorder. While highly effective therapeutic options exist, esophageal cancer remains a long-term potential complication. The risk of esophageal cancer in achalasia remains unclear, with current guidelines recommending against routine endoscopic screening. However, given limited data and conflicting opinion, it is unknown whether consensus regarding screening practices in achalasia among experts exists. A 10-question survey to assess screening practices in achalasia was created and distributed to 28 experts in the area of achalasia. Experts were identified based on publications and meeting presentations in the field. Survey responses were received from 17 of 28 (61%) experts. Wide geographic distribution was seen among respondents, with eight (47%) from Europe or Australia, seven (41%) from the United States, and two (12%) from Asia. Screening for esophageal cancer was inconsistent, with nine (53%) experts endorsing the practice and eight (47%) not. Screening practices did not differ among geographic regions. No consensus regarding the risk for esophageal cancer in achalasia was seen, with three experts reporting no increased risk compared with the general population, eight experts a lifetime risk of 0.1-0.5%, three experts a 0.5-1% risk, two experts a 1-2% risk, and one expert a 3-5% risk. However, these differences in perception of risk did not influence screening practices. Upper endoscopy was utilized among all experts who endorsed screening. However, practices still varied with screening commencing at or within 1 year of diagnosis in two practices compared with 5 and 10 years in three respective practices each. Surveillance intervals also varied, performed every 2 years in four practices, every 3 years in four practices, and every 5 years in one practice. Practice variation in the management of achalasia itself was also seen, with initial treatment with Heller myotomy endorsed by eight experts, pneumatic

  9. Influenza among the elderly in the Americas: a consensus statement.

    PubMed

    Rüttimann, Ricardo W; Bonvehí, Pablo E; Vilar-Compte, Diana; Isturiz, Raúl E; Labarca, Jaime A; Vidal, Edison I

    2013-06-01

    Influenza exacts a heavy burden on the elderly, a segment of the population that is estimated to experience rapid growth in the near future. In the past decade most developed and several developing countries have recommended influenza vaccination for those > 65 years of age. The World Health Organization (WHO) set a goal of 75% influenza vaccination coverage among the elderly by 2010, but it was not achieved. In 2011, the Technical Advisory Group at the Pan American Health Organization, Regional Office of WHO for the Americas, reiterated the influenza vaccine recommendation for older adults. Relatively little information has been compiled on the immunological aspect of aging or on reducing its impact, information particularly relevant for clinicians and gerontologist with firsthand experience confronting its effects. To fill this data gap, in 2012 the Americas Health Foundation (Washington, D.C., United States) and the nonprofit, Fighting Infectious Diseases in Emerging Countries (Miami, Florida, United States), convened a panel of Latin American clinicians and gerontologists with expertise in influenza to discuss key issues and develop a consensus statement. The major recommendations were to improve influenza surveillance throughout Latin America so that its impact can be quantified; and to conduct laboratory confirmation of influenza for all patients who have flu-like symptoms and are frail, immunosuppressed, have comorbidities, are respiratory compromised, or have been admitted to a hospital. The panel also noted that: since evidence for antivirals in the elderly is unclear, their use should be handled on a case-by-case basis; despite decreased immunological response, influenza vaccination in older adults is still crucial; indirect immunization strategies should be encouraged; and traditional infection control measures are essential in long-term care facilities.

  10. 43 CFR 46.110 - Incorporating consensus-based management.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... carry out those plans and activities. For the purposes of this Part, consensus-based management involves..., whenever practicable, use a consensus-based management approach to the NEPA process. (d) If the Responsible... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Incorporating consensus-based...

  11. 43 CFR 46.110 - Incorporating consensus-based management.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... carry out those plans and activities. For the purposes of this Part, consensus-based management involves..., whenever practicable, use a consensus-based management approach to the NEPA process. (d) If the Responsible... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Incorporating consensus-based...

  12. 43 CFR 46.110 - Incorporating consensus-based management.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... carry out those plans and activities. For the purposes of this Part, consensus-based management involves..., whenever practicable, use a consensus-based management approach to the NEPA process. (d) If the Responsible... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Incorporating consensus-based...

  13. 43 CFR 46.110 - Incorporating consensus-based management.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... carry out those plans and activities. For the purposes of this Part, consensus-based management involves..., whenever practicable, use a consensus-based management approach to the NEPA process. (d) If the Responsible... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Incorporating consensus-based...

  14. A Self-Categorization Explanation for Opinion Consensus Perceptions

    ERIC Educational Resources Information Center

    Zhang, Jinguang; Reid, Scott A.

    2013-01-01

    The public expression of opinions (and related communicative activities) hinges upon the perception of opinion consensus. Current explanations for opinion consensus perceptions typically focus on egocentric and other biases, rather than functional cognitions. Using self-categorization theory we showed that opinion consensus perceptions flow from…

  15. Lack of Consensus on Education: What Are Its Dimensions?

    ERIC Educational Resources Information Center

    Rozycki, Edward G.

    2010-01-01

    This article offers an analysis of the dimensions of consensus on education using Diane Ravitch's statement: "The single biggest problem in American education is that no one agrees on why they educate." The interesting problem is to determine which consensus on educational issues varies, whose consensus it is, and how and why it varies. The author…

  16. Comparison of the Wells score with the revised Geneva score for assessing suspected pulmonary embolism: a systematic review and meta-analysis.

    PubMed

    Shen, Jun-Hua; Chen, Hong-Lin; Chen, Jian-Rong; Xing, Jia-Li; Gu, Peng; Zhu, Bao-Feng

    2016-04-01

    The Wells score and the revised Geneva score are two most commonly used clinical rules for excluding pulmonary embolism (PE). In this study, we aimed to assess the diagnostic accuracy of these two rules; we also compared the diagnostic accuracy between them. We searched PubMed and Web of science up to April 2015. Studies assessed Wells score and revised Geneva score for diagnosis suspected PE were included. The summary area under the curve (AUC) and the 95 % confidence interval (CI) were calculated. Eleven studies were included in this meta-analysis. For Wells score, the sensitivity ranged from 63.8 to 79.3 %, and the specificity ranged from 48.8 to 90.0 %. The overall weighted AUC was 0.778 (95 % CI 0.740-0.818; Z = 9.88, P < 0.001). For revised Geneva score, the sensitivity ranged from 55.3 to 73.6 %. The overall weighted AUC was 0.693 (95 % CI 0.653-0.736; Z = 11.96, P < 0.001). 95 % CIs of two AUCs were not overlapped, which indicated Wells score was more accurate than revised Geneva score for predicting PE in suspected patients. Meta-regression showed diagnostic accuracy of these two rules was not related with PE prevalence. Sensitivity analysis by only included prospective studies showed the results were robust. Our results showed the Wells score was more effective than the revised Geneva score in discriminate PE in suspected patients.

  17. Bruxism defined and graded: an international consensus.

    PubMed

    Lobbezoo, F; Ahlberg, J; Glaros, A G; Kato, T; Koyano, K; Lavigne, G J; de Leeuw, R; Manfredini, D; Svensson, P; Winocur, E

    2013-01-01

    To date, there is no consensus about the definition and diagnostic grading of bruxism. A written consensus discussion was held among an international group of bruxism experts as to formulate a definition of bruxism and to suggest a grading system for its operationalisation. The expert group defined bruxism as a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. Bruxism has two distinct circadian manifestations: it can occur during sleep (indicated as sleep bruxism) or during wakefulness (indicated as awake bruxism). For the operationalisation of this definition, the expert group proposes a diagnostic grading system of 'possible', 'probable' and 'definite' sleep or awake bruxism. The proposed definition and grading system are suggested for clinical and research purposes in all relevant dental and medical domains.

  18. Consensus and transitions in coupled Sznajd networks

    NASA Astrophysics Data System (ADS)

    Ludden, Matthew

    2013-03-01

    In this work we investigate two coupled square lattice networks undergoing Sznajd model dynamics. The coupling between the networks is quantified by a coupling strength p. Monte Carlo simulations indicate that the exit probability of each network (to reach either all spins up or all down) depends on p and the initial density of up spins d in the other network. For fixed initial densities, we find a critical coupling pc, above which no further changes in the exit probability are observed. We also find pc to decrease linearly with increasing d. The consensus time scales with system size as Lα, where α = α(p, d). The conditions that must be met for the two networks to reach consensus are also considered. Thomas E. Stone: Husson University, Susan R. McKay: University of Maine

  19. The Temporal Structure of Scientific Consensus Formation

    PubMed Central

    Shwed, Uri; Bearman, Peter S.

    2011-01-01

    This article engages with problems that are usually opaque: What trajectories do scientific debates assume, when does a scientific community consider a proposition to be a fact, and how can we know that? We develop a strategy for evaluating the state of scientific contestation on issues. The analysis builds from Latour’s black box imagery, which we observe in scientific citation networks. We show that as consensus forms, the importance of internal divisions to the overall network structure declines. We consider substantive cases that are now considered facts, such as the carcinogenicity of smoking and the non-carcinogenicity of coffee. We then employ the same analysis to currently contested cases: the suspected carcinogenicity of cellular phones, and the relationship between vaccines and autism. Extracting meaning from the internal structure of scientific knowledge carves a niche for renewed sociological commentary on science, revealing a typology of trajectories that scientific propositions may experience en route to consensus. PMID:21886269

  20. Consensus Protein Design Without Phylogenetic Bias

    PubMed Central

    Jäckel, Christian; Bloom, Jesse D; Kast, Peter; Arnold, Frances H; Hilvert, Donald

    2010-01-01

    Consensus design is an appealing strategy for the stabilization of proteins. It exploits amino acid conservation in sets of homologous proteins to identify likely beneficial mutations. Nevertheless, its success depends on the phylogenetic diversity of the sequence set available. Here we show that randomization of a single protein represents a reliable alternative source of sequence diversity essentially free of phylogenetic bias. A small number of functional protein sequences selected from binary-patterned libraries suffices as input for consensus design of active enzymes that are easier to produce and substantially more stable than individual members of the starting data set. Although catalytic activity correlates less consistently with sequence conservation in these extensively randomized proteins, less extreme mutagenesis strategies might be adopted in practice to augment stability while maintaining function. PMID:20433850

  1. Updated Lightning Safety Recommendations.

    ERIC Educational Resources Information Center

    Vavrek, R. James; Holle, Ronald L.; Lopez, Raul E.

    1999-01-01

    Summarizes the recommendations of the Lightning Safety Group (LSG), which was first convened during the 1998 American Meteorological Society Conference. Findings outline appropriate actions under various circumstances when lightning threatens. (WRM)

  2. Recommended Textbooks (Booksearch).

    ERIC Educational Resources Information Center

    English Journal, 1988

    1988-01-01

    Evaluates four textbooks recommended by junior high and high school teachers for teaching writing and literature: "Enjoying Literature" (published by Macmillan, 1985); "Exposition: Critical Writing and Thinking" (Robert J. Gula); "Situational Writing" (Gene Krupa); and "Double Exposure: Composing through Writing…

  3. [Second Clinical Consensus of the Ibero-American Society of Neonatology: hemodynamic management of newborns].

    PubMed

    Golombek, Sergio G; Fariña, Diana; Sola, Augusto; Baquero, Hernando; Cabañas, Fernando; Dominguez, Fernando; Fajardo, Carlos; Goldsmit, Gustavo S; Flores, Gabriel Lara; Lee, Mario; Varela, Lourdes Lemus; Mariani, Gonzalo; Miura, Ernani; Pérez, Jose Maria; Zambosco, Guillermo; Pellicer, Adelina; Bancalari, Eduardo

    2011-04-01

    This study reports on the process and results of the Second Clinical Consensus of the Ibero-American Society of Neonatology. Eighty neonatologists from 23 countries were invited to collaborate and participate in the event. Several questions of clinical-physiological importance in the hemodynamic management of newborns were addressed. Participants were divided into groups to facilitate interaction and teamwork, with instructions to respond to three to five questions by analyzing the literature and local factors. Meeting in Mar del Plata, Argentina, the Consensus Group served as a form for various presentations and discussions. In all, 54 neonatologists from 21 countries attended, with the objective of reaching a consensus on such matters as concepts and definitions of hemodynamic instability, the physiopathology of hemodynamic compromise, recommended therapy strategies, and hemodynamic monitoring. It is hoped that this international experience will serve as a useful initiative for future consensus building and reduction of the existing disparities among the countries of the Region in terms of treatment and outcomes.

  4. After seven years, where's the consensus

    SciTech Connect

    Norman, M.R.

    1993-04-01

    It has been 7 years since the discovery of copper oxide superconductors, yet there is no consensus on the correct theory for this phenomenon. The theory can be divided into 3 groups: ordinary (phonons), exotic (AF spin fluctuations, nested Fermi liquid, excitons, spin bags, odd frequency pairing), and revolutionary (Luttinger liquid, spin-charge separation, gauge theories, anyons, marginal Fermi liquid). C-axis dispersion, dHvA, and magneto-oscillations are also discussed.

  5. Shoulder biomechanics: today's consensus and tomorrow's perspectives.

    PubMed

    Cutti, Andrea Giovanni; Veeger, H E J DirkJan

    2009-05-01

    Shoulder biomechanics is a fast growing field, which is progressively expanding its focus to include more applied research. The papers included in this Special Issue confirm this trend. After a classification of the papers as dealing with fundamental or applied research through theoretical or experimental methods, in this Editorial we tried to summarize the elements of consensus and the open issues discussed during the last International Shoulder Group meeting, held in Bologna (Italy) in 2008.

  6. Design Review Improvement Recommendations

    DTIC Science & Technology

    2015-06-18

    program execution and mission operations in spite of significant advances in design and analysis tool capabilities and robust command media governing...level of risk a program is willing to accept based on its design heritage . The recommendations in this report complement, but do not duplicate, the...recommendations provided in the following TORs: • Design Assurance Guide, Aerospace Report No.TOR-2009 (8591)-11 • Objective Re-use of Heritage

  7. Antibiotic resistant bacteria/genes dissemination in lacustrine sediments highly increased following cultural eutrophication of Lake Geneva (Switzerland).

    PubMed

    Thevenon, Florian; Adatte, Thierry; Wildi, Walter; Poté, John

    2012-02-01

    This study investigates faecal indicator bacteria (FIB), multiple antibiotic resistant (MAR), and antibiotic resistance genes (ARGs), of sediment profiles from different parts of Lake Geneva (Switzerland) over the last decades. MARs consist to expose culturable Escherichia coli (EC) and Enterococcus (ENT) to mixed five antibiotics including Ampicillin, Tetracycline, Amoxicillin, Chloramphenicol and Erythromycin. Culture-independent is performed to assess the distribution of ARGs responsible for, β-lactams (blaTEM; Amoxicillin/Ampicillin), Streptomycin/Spectinomycin (aadA), Tetracycline (tet) Chloramphenicol (cmlA) and Vancomycin (van). Bacterial cultures reveal that in the sediments deposited following eutrophication of Lake Geneva in the 1970s, the percentage of MARs to five antibiotics varied from 0.12% to 4.6% and 0.016% to 11.6% of total culturable EC and ENT, respectively. In these organic-rich bacteria-contaminated sediments, the blaTEM resistant of FIB varied from 22% to 48% and 16% to 37% for EC and ENT respectively, whereas the positive PCR assays responsible for tested ARGs were observed for EC, ENT, and total DNA from all samples. The aadA resistance gene was amplified for all the sediment samples, including those not influenced by WWTP effluent water. Our results demonstrate that bacteria MARs and ARGs highly increased in the sediments contaminated with WWTP effluent following the cultural eutrophication of Lake Geneva. Hence, the human-induced changing limnological conditions highly enhanced the sediment microbial activity, and therein the spreading of antibiotic resistant bacteria and genes in this aquatic environment used to supply drinking water in a highly populated area. Furthermore, the presence of the antibiotic resistance gene aadA in all the studied samples points out a regional dissemination of this emerging contaminant in freshwater sediments since at least the late nineteenth century.

  8. Consensus contact prediction by linear programming.

    PubMed

    Gao, Xin; Bu, Dongbo; Li, Shuai Cheng; Li, Ming; Xu, Jinbo

    2007-01-01

    Protein inter-residue contacts are of great use for protein structure determination or prediction. Recent CASP events have shown that a few accurately predicted contacts can help improve both computational efficiency and prediction accuracy of the ab inito folding methods. This paper develops an integer linear programming (ILP) method for consensus-based contact prediction. In contrast to the simple "majority voting" method assuming that all the individual servers are equal and independent, our method evaluates their correlations using the maximum likelihood method and constructs some latent independent servers using the principal component analysis technique. Then, we use an integer linear programming model to assign weights to these latent servers in order to maximize the deviation between the correct contacts and incorrect ones; our consensus prediction server is the weighted combination of these latent servers. In addition to the consensus information, our method also uses server-independent correlated mutation (CM) as one of the prediction features. Experimental results demonstrate that our contact prediction server performs better than the "majority voting" method. The accuracy of our method for the top L/5 contacts on CASP7 targets is 73.41%, which is much higher than previously reported studies. On the 16 free modeling (FM) targets, our method achieves an accuracy of 37.21%.

  9. Molecular subgroups of medulloblastoma: the current consensus.

    PubMed

    Taylor, Michael D; Northcott, Paul A; Korshunov, Andrey; Remke, Marc; Cho, Yoon-Jae; Clifford, Steven C; Eberhart, Charles G; Parsons, D Williams; Rutkowski, Stefan; Gajjar, Amar; Ellison, David W; Lichter, Peter; Gilbertson, Richard J; Pomeroy, Scott L; Kool, Marcel; Pfister, Stefan M

    2012-04-01

    Medulloblastoma, a small blue cell malignancy of the cerebellum, is a major cause of morbidity and mortality in pediatric oncology. Current mechanisms for clinical prognostication and stratification include clinical factors (age, presence of metastases, and extent of resection) as well as histological subgrouping (classic, desmoplastic, and large cell/anaplastic histology). Transcriptional profiling studies of medulloblastoma cohorts from several research groups around the globe have suggested the existence of multiple distinct molecular subgroups that differ in their demographics, transcriptomes, somatic genetic events, and clinical outcomes. Variations in the number, composition, and nature of the subgroups between studies brought about a consensus conference in Boston in the fall of 2010. Discussants at the conference came to a consensus that the evidence supported the existence of four main subgroups of medulloblastoma (Wnt, Shh, Group 3, and Group 4). Participants outlined the demographic, transcriptional, genetic, and clinical differences between the four subgroups. While it is anticipated that the molecular classification of medulloblastoma will continue to evolve and diversify in the future as larger cohorts are studied at greater depth, herein we outline the current consensus nomenclature, and the differences between the medulloblastoma subgroups.

  10. Inaugural meeting of the malaria policy advisory committee to the WHO: conclusions and recommendations

    PubMed Central

    2012-01-01

    The Malaria Policy Advisory Committee to the World Health Organization met for the first time from 31 January to 2 February 2012 in Geneva, Switzerland. This article provides a summary of the discussions, conclusions and recommendations from that meeting, as part of the newly launched Malaria Journal thematic series “WHO Malaria Policy Advisory Committee: Reports and Recommendations”. Summaries are provided, referencing the relevant background documents, for the meeting sessions on global malaria control, drug resistance and containment, rapid diagnostic test procurement criteria, larviciding, classification of countries for elimination, estimating malaria cases and deaths, and seasonal malaria chemoprevention. Policy statements, position statements, and guidelines that will arise from the MPAC meeting conclusions and recommendations will be formally issued and disseminated to World Health Organization member states by the World Health Organization Global Malaria Programme. PMID:22545931

  11. Malaria Policy Advisory Committee to the WHO: conclusions and recommendations of fifth biannual meeting (March 2014).

    PubMed

    2014-07-03

    The Malaria Policy Advisory Committee to the World Health Organization (WHO) held its fifth meeting in Geneva, Switzerland from 12 to 14 March 2014. This article provides a summary of the discussions, conclusions and recommendations from that meeting.Meeting sessions covered: maintaining universal coverage of long-lasting insecticidal nets; combining indoor residual spraying with long-lasting insecticidal nets; the sound management of old long-lasting insecticidal nets; malaria diagnosis in low transmission settings; the Global Technical Strategy for Malaria (2016 -2025); and Technical Expert Group updates on vector control, the RTS,S vaccine, the Malaria Treatment Guidelines, anti-malarial drug resistance and containment, and surveillance, monitoring and evaluation.Policy statements, position statements, and guidelines that arise from the Malaria Policy Advisory Committee meeting conclusions and recommendations will be formally issued and disseminated to WHO Member States by the WHO Global Malaria Programme.

  12. Social Tagging Recommender Systems

    NASA Astrophysics Data System (ADS)

    Marinho, Leandro Balby; Nanopoulos, Alexandros; Schmidt-Thieme, Lars; Jäschke, Robert; Hotho, Andreas; Stumme, Gerd; Symeonidis, Panagiotis

    The new generation of Web applications known as (STS) is successfully established and poised for continued growth. STS are open and inherently social; features that have been proven to encourage participation. But while STS bring new opportunities, they revive old problems, such as information overload. Recommender Systems are well known applications for increasing the level of relevant content over the "noise" that continuously grows as more and more content becomes available online. In STS however, we face new challenges. Users are interested in finding not only content, but also tags and even other users. Moreover, while traditional recommender systems usually operate over 2-way data arrays, STS data is represented as a third-order tensor or a hypergraph with hyperedges denoting (user, resource, tag) triples. In this chapter, we survey the most recent and state-of-the-art work about a whole new generation of recommender systems built to serve STS.We describe (a) novel facets of recommenders for STS, such as user, resource, and tag recommenders, (b) new approaches and algorithms for dealing with the ternary nature of STS data, and (c) recommender systems deployed in real world STS. Moreover, a concise comparison between existing works is presented, through which we identify and point out new research directions.

  13. Report from the 17th Annual Western Canadian Gastrointestinal Cancer Consensus Conference; Edmonton, Alberta; 11–12 September 2015

    PubMed Central

    Mulder, K.E.; Ahmed, S.; Davies, J.D.; Doll, C.M.; Dowden, S.; Gill, S.; Gordon, V.; Hebbard, P.; Lim, H.; McFadden, A.; McGhie, J.P.; Park, J.; Wong, R.

    2016-01-01

    The 17th annual Western Canadian Gastrointestinal Cancer Consensus Conference (wcgccc) was held in Edmonton, Alberta, 11–12 September 2015. The wcgccc is an interactive multidisciplinary conference attended by health care professionals from across Western Canada (British Columbia, Alberta, Saskatchewan, and Manitoba) who are involved in the care of patients with gastrointestinal cancer. Surgical, medical, and radiation oncologists; pathologists; radiologists; and allied health care professionals participated in presentation and discussion sessions for the purposes of developing the recommendations presented here. This consensus statement addresses current issues in the management of gastric cancer. PMID:28050139

  14. Filling the Gap - Improving Awareness and Practice in Hyponatraemia and the Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) in the Older Patient: A European Consensus View.

    PubMed

    Wehling, M; Ashton, C; Ekpo, E; Gwynn, S; Laville, M; Olsson, K; Spring, M

    2017-01-01

    Introduction: Causes of hyponatraemia in older patients are multivariate and in the case of SIADH may often be drug induced. Diagnostic and treatment algorithms are unclear for this important age group. Methods: The author group identified 6 broad themes for consensus and formulated 42 separate consensus statements within these 6 themes. Statements were then circulated to geriatricians, general practitioners and other doctors to test agreement at the European level. Results: 64 responses were evaluated from around Europe. Agreement was achieved in 86% of the statements following amendment and redistribution of 6 of the statements. The survey and its feedback prompted the development of 13 recommendations related to the diagnosis and treatment of hyponatraemia including SIADH. Conclusion: The series of 13 recommendations developed here is intended to increase clarity for clinicians managing older patients with hyponatraemia and SIADH. Surprisingly, despite the lack of clear guidelines or recommendations for this age group consensus levels for the author-based statements were high among the respondents.

  15. Correction: Washington and Geneva arrive in Buenos Aires: notes on the history of the habit of smoking and its medicalization.

    PubMed

    2015-12-01

    [This corrects the article DOI: 10.1590/S0104-59702015000100017.]. Upon request of the author, the article "Washington and Geneva come to Buenos Aires: notes on the history of smoking and its medicalization" by Diego Armus, publicado em História, Ciências, Saúde - Manguinhos, v.22, n.1 , Jan.-Mar. 2015:on page 301, second paragraph, sixth line, where it says " It was only in 2012 when Argentina ratified the agreement and the National Congress approved a new national law" it should read "It was only in 2012, without having ratified the convention, when the National Congress approved a new national law. "

  16. Towards a consensus on diagnostic criteria, measurement and trial design of the premenstrual disorders: the ISPMD Montreal consensus

    PubMed Central

    Bäckström, Torbjorn; Brown, Candace; Dennerstein, Lorraine; Endicott, Jean; Epperson, C. Neill; Eriksson, Elias; Freeman, Ellen; Halbreich, Uriel; Ismail, Khaled M. K.; Panay, Nicholas; Pearlstein, Teri; Rapkin, Andrea; Reid, Robert; Schmidt, Peter; Steiner, Meir; Studd, John; Yonkers, Kimberley

    2014-01-01

    Premenstrual disorders (PMD) are characterised by a cluster of somatic and psychological symptoms of varying severity that occur during the luteal phase of the menstrual cycle and resolve during menses (Freeman and Sondheimer, Prim Care Companion J Clin Psychiatry 5:30–39, 2003; Halbreich, Gynecol Endocrinol 19:320–334, 2004). Although PMD have been widely recognised for many decades, their precise cause is still unknown and there are no definitive, universally accepted diagnostic criteria. To consider this issue, an international multidisciplinary group of experts met at a face-to-face consensus meeting to review current definitions and diagnostic criteria for PMD. This was followed by extensive correspondence. The consensus group formally became established as the International Society for Premenstrual Disorders (ISPMD). The inaugural meeting of the ISPMD was held in Montreal in September 2008. The primary aim was to provide a unified approach for the diagnostic criteria of PMD, their quantification and guidelines on clinical trial design. This report summarises their recommendations. It is hoped that the criteria proposed here will inform discussions of the next edition of the World Health Organisation's International Classification of Diseases (ICD-11), and the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V) criteria that are currently under consideration. It is also hoped that the proposed definitions and guidelines could be used by all clinicians and investigators to provide a consistent approach to the diagnosis and treatment of PMD and to aid scientific and clinical research in this field. PMID:21225438

  17. Emerging treatments in neurogastroenterology: a multidisciplinary working group consensus statement on opioid-induced constipation

    PubMed Central

    CAMILLERI, M.; DROSSMAN, D. A.; BECKER, G.; WEBSTER, L. R.; DAVIES, A. N.; MAWE, G. M.

    2015-01-01

    Background Opioids are effective for acute and chronic pain conditions, but their use is associated with often difficult-to-manage constipation and other gastrointestinal (GI) effects due to effects on peripheral μ-opioid receptors in the gut. The mechanism of opioid-induced constipation (OIC) differs from that of functional constipation (FC), and OIC may not respond as well to most first-line treatments for FC. The impact of OIC on quality of life (QoL) induces some patients to decrease or stop their opioid therapy to relieve or avoid constipation. Purpose At a roundtable meeting on OIC, a working group developed a consensus definition for OIC diagnosis across disciplines and reviewed current OIC treatments and the potential of treatments in development. By consensus, OIC is defined as follows: ‘A change when initiating opioid therapy from baseline bowel habits that is characterized by any of the following: reduced bowel movement frequency, development or worsening of straining to pass bowel movements, a sense of incomplete rectal evacuation, or harder stool consistency’. The working group noted the prior validation of a patient response outcome and end point for clinical trials and recommended future efforts to create treatment guidelines and QoL measures specific for OIC. Details from the working group’s discussion and consensus recommendations for patient care and research are presented in this article. PMID:25164154

  18. European Headache Federation consensus on technical investigation for primary headache disorders.

    PubMed

    Mitsikostas, D D; Ashina, M; Craven, A; Diener, H C; Goadsby, P J; Ferrari, M D; Lampl, C; Paemeleire, K; Pascual, J; Siva, A; Olesen, J; Osipova, V; Martelletti, P

    2015-01-01

    The diagnosis of primary headache disorders is clinical and based on the diagnostic criteria of the International Headache Society (ICHD-3-beta). However several brain conditions may mimic primary headache disorders and laboratory investigation may be needed. This necessity occurs when the treating physician doubts for the primary origin of headache. Features that represent a warning for a possible underlying disorder causing the headache are new onset headache, change in previously stable headache pattern, headache that abruptly reaches the peak level, headache that changes with posture, headache awakening the patient, or precipitated by physical activity or Valsalva manoeuvre, first onset of headache ≥50 years of age, neurological symptoms or signs, trauma, fever, seizures, history of malignancy, history of HIV or active infections, and prior history of stroke or intracranial bleeding. All national headache societies and the European Headache Alliance invited to review and comment the consensus before the final draft. The consensus recommends brain MRI for the case of migraine with aura that persists on one side or in brainstem aura. Persistent aura without infarction and migrainous infarction require brain MRI, MRA and MRV. Brain MRI with detailed study of the pituitary area and cavernous sinus, is recommended for all TACs. For primary cough headache, exercise headache, headache associated with sexual activity, thunderclap headache and hypnic headache apart from brain MRI additional tests may be required. Because there is little and no good evidence the committee constructed a consensus based on the opinion of experts, and should be treated as imperfect.

  19. Adult immunization in India: Importance and recommendations.

    PubMed

    Verma, Ramesh; Khanna, Pardeep; Chawla, Suraj

    2015-01-01

    Vaccination is recommended throughout life to prevent infectious diseases and their sequelae. Vaccines are crucial to prevent mortality in that >25% of deaths are due to infections. Vaccines are recommended for adults on the basis of a range of factors. Substantial improvement and increases in adult vaccination are needed to reduce the health consequences of vaccine-preventable diseases among adults. Incomplete and inadequate immunization in India against these communicable diseases results in substantial and unnecessary costs both in terms of hospitalization and treatment. The government of India as well as the World Health Organization (WHO) consider childhood vaccination as the first priority, but there is not yet focus on adult immunization. Adult immunization in India is the most ignored part of heath care services. The Expert Group recommended that data on infectious diseases in India should be updated, refined, and reviewed periodically and published regularly. This group suggested that the consensus guidelines about adult immunization should be reviewed every 3 years to incorporate new strategies from any emerging research from India. There is an immediate need to address the problem of adult immunization in India. Although many issues revolving around efficacy, safety, and cost of introducing vaccines for adults at the national level are yet to be resolved, there is an urgent need to sensitize the health planners as well as health care providers regarding this pertinent issue.

  20. A Request for Planning Funds for a Research and Study Abroad Facility in Geneva, Switzerland in Affiliation with the European Laboratory for Particle Physics

    SciTech Connect

    campbell, myron

    2013-03-31

    To create a research and study abroad program that would allow U.S. undergraduate students access to the world-leading research facilities at the European Organization for Nuclear Research (CERN), the World Health Organization, various operations of the United Nations and other international organizations based in Geneva.The proposal is based on the unique opportunities currently existing in Geneva. The Large Hadron Collider (LHC) is now operational at CERN, data are being collected, and research results are already beginning to emerge. At the same time, a related reduction of activity at U.S. facilities devoted to particle physics is expected. In addition, the U.S. higher-education community has an ever-increasing focus on international organizations dealing with world health pandemics, arms control and human rights, a nexus also centered in Geneva.

  1. Aetiological diagnosis of child deafness: CODEPEH recommendations.

    PubMed

    Núñez-Batalla, Faustino; Jáudenes-Casaubón, Carmen; Sequí-Canet, Jose Miguel; Vivanco-Allende, Ana; Zubicaray-Ugarteche, Jose; Cabanillas-Farpón, Rubén

    Important progress in the fields of molecular genetics (principally) and diagnostic imaging, together with the lack of a consensus protocol for guiding the diagnostic process after confirming deafness by neonatal screening, have led to this new work document drafted by the Spanish Commission for the Early Detection of Child Deafness (Spanish acronym: CODEPEH). This 2015 Recommendations Document, which is based on the most recent scientific evidence, provides guidance to professionals to support them in making decisions regarding aetiological diagnosis. Such diagnosis should be performed without delay and without impeding early intervention. Early identification of the causes of deafness offers many advantages: it prevents unnecessary trouble for the families, reduces health system expenses caused by performing different tests, and provides prognostic information that may guide therapeutic actions.

  2. A Multiscale Surface Water Temperature Data Acquisition Platform: Tests on Lake Geneva, Switzerland

    NASA Astrophysics Data System (ADS)

    Barry, D. A.; Irani Rahaghi, A.; Lemmin, U.; Riffler, M.; Wunderle, S.

    2015-12-01

    An improved understanding of surface transport processes is necessary to predict sediment, pollutant and phytoplankton patterns in large lakes. Lake surface water temperature (LSWT), which varies in space and time, reflects meteorological and climatological forcing more than any other physical lake parameter. There are different data sources for LSWT mapping, including remote sensing and in situ measurements. Satellite data can be suitable for detecting large-scale thermal patterns, but not meso- or small scale processes. Lake surface thermography, investigated in this study, has finer resolution compared to satellite images. Thermography at the meso-scale provides the ability to ground-truth satellite imagery over scales of one to several satellite image pixels. On the other hand, thermography data can be used as a control in schemes to upscale local measurements that account for surface energy fluxes and the vertical energy budget. Independently, since such data can be collected at high frequency, they can be also useful in capturing changes in the surface signatures of meso-scale eddies and thus to quantify mixing processes. In the present study, we report results from a Balloon Launched Imaging and Monitoring Platform (BLIMP), which was developed in order to measure the LSWT at meso-scale. The BLIMP consists of a small balloon that is tethered to a boat and equipped with thermal and RGB cameras, as well as other instrumentation for location and communication. Several deployments were carried out on Lake Geneva. In a typical deployment, the BLIMP is towed by a boat, and collects high frequency data from different heights (i.e., spatial resolutions) and locations. Simultaneous ground-truthing of the BLIMP data is achieved using an autonomous craft that collects a variety of data, including in situ surface/near surface temperatures, radiation and meteorological data in the area covered by the BLIMP images. With suitable scaling, our results show good consistency

  3. 6th Annual European Antibody Congress 2010: November 29-December 1, 2010, Geneva, Switzerland.

    PubMed

    Beck, Alain; Wurch, Thierry; Reichert, Janice M

    2011-01-01

    The 6th European Antibody Congress (EAC), organized by Terrapinn Ltd., was held in Geneva, Switzerland, which was also the location of the 4th and 5th EAC. As was the case in 2008 and 2009, the EAC was again the largest antibody congress held in Europe, drawing nearly 250 delegates in 2010. Numerous pharmaceutical and biopharmaceutical companies active in the field of therapeutic antibody development were represented, as were start-up and academic organizations and representatives from the US Food and Drug Administration FDA. The global trends in antibody research and development were discussed, including success stories of recent marketing authorizations of golimumab (Simponi®) and canakinumab (Ilaris®) by Johnson & Johnson and Novartis, respectively, updates on antibodies in late clinical development (obinutuzumab/GA101, farletuzumab/MORAb-003 and itolizumab/T1 h, by Glycart/Roche, Morphotek and Biocon, respectively) and success rates for this fast-expanding class of therapeutics (Tufts Center for the Study of Drug Development). Case studies covering clinical progress of girentuximab (Wilex), evaluation of panobacumab (Kenta Biotech), characterization of therapeutic antibody candidates by protein microarrays (Protagen), antibody-drug conjugates (sanofi-aventis, ImmunoGen, Seattle Genetics, Wyeth/Pfizer), radio-immunoconjugates (Bayer Schering Pharma, Université de Nantes) and new scaffolds (Ablynx, AdAlta, Domantis/GlaxoSmithKline, Fresenius, Molecular Partners, Pieris, Scil Proteins, Pfizer, University of Zurich) were presented. Major antibody structural improvements were showcased, including the latest selection engineering of the best isotypes (Abbott, Pfizer, Pierre Fabre), hinge domain (Pierre Fabre), dual antibodies (Abbott), IgG-like bispecific antibodies (Biogen Idec), antibody epitope mapping case studies (Eli Lilly), insights in FcγRII receptor (University of Cambridge), as well as novel tools for antibody fragmentation (Genovis). Improvements of

  4. Distributed Deliberative Recommender Systems

    NASA Astrophysics Data System (ADS)

    Recio-García, Juan A.; Díaz-Agudo, Belén; González-Sanz, Sergio; Sanchez, Lara Quijano

    Case-Based Reasoning (CBR) is one of most successful applied AI technologies of recent years. Although many CBR systems reason locally on a previous experience base to solve new problems, in this paper we focus on distributed retrieval processes working on a network of collaborating CBR systems. In such systems, each node in a network of CBR agents collaborates, arguments and counterarguments its local results with other nodes to improve the performance of the system's global response. We describe D2ISCO: a framework to design and implement deliberative and collaborative CBR systems that is integrated as a part of jcolibritwo an established framework in the CBR community. We apply D2ISCO to one particular simplified type of CBR systems: recommender systems. We perform a first case study for a collaborative music recommender system and present the results of an experiment of the accuracy of the system results using a fuzzy version of the argumentation system AMAL and a network topology based on a social network. Besides individual recommendation we also discuss how D2ISCO can be used to improve recommendations to groups and we present a second case of study based on the movie recommendation domain with heterogeneous groups according to the group personality composition and a group topology based on a social network.

  5. International consensus on ANA patterns (ICAP): the bumpy road towards a consensus on reporting ANA results.

    PubMed

    Damoiseaux, Jan; von Mühlen, Carlos A; Garcia-De La Torre, Ignacio; Carballo, Orlando Gabriel; de Melo Cruvinel, Wilson; Francescantonio, Paulo Luiz Carvalho; Fritzler, Marvin J; Herold, Manfred; Mimori, Tsuneyo; Satoh, Minoru; Andrade, Luis E C; Chan, Edward K L; Conrad, Karsten

    2016-12-01

    The International Consensus on ANA Patterns (ICAP) was initiated as a workshop aiming to thoroughly discuss and achieve consensus regarding the morphological patterns observed in the indirect immunofluorescence assay on HEp-2 cells. One of the topics discussed at the second ICAP workshop, and addressed in this paper, was the harmonization of reporting ANA test results. This discussion centered on the issue if cytoplasmic and mitotic patterns should be reported as positive or negative. This report outlines the issues that impact on two major different reporting methods. Although it was appreciated by all participants that cytoplasmic and mitotic patterns are clinically relevant, implications for existing diagnostic/classification criteria for ANA-associated diseases in particular hampered a final consensus on this topic. Evidently, a more concerted action of all relevant stakeholders is required. Future ICAP workshops may help to facilitate this action.

  6. Consensus for improving the comprehensive care of patients with acute heart failure: summarised version.

    PubMed

    Manito Lorite, N; Manzano Espinosa, L; Llorens Soriano, P; Masip Utset, J; Comín Colet, J; Formiga Pérez, F; Herrero Puente, P; Delgado Jiménez, J; Montero-Pérez-Barquero, M; Jacob Rodríguez, J; López de Sá Areses, E; Pérez Calvo, J I; Martín-Sánchez, F J; Miró Andreu, Ò

    2016-01-01

    The purpose of this consensus document was to reach an agreement among experts on the multidisciplinary care of patients with acute heart failure. Starting with a narrative review of the care provided to these patients and a critical analysis of the healthcare procedures, we identified potential shortcomings and improvements and formalised a document on recommendations for optimising the clinical and therapeutic approach for acute heart failure. This document was validated through an in-person group session guided using participatory techniques. The process resulted in a set of 36 recommendations formulated by experts of the Spanish Society of Cardiology, the Spanish Society of Internal Medicine and the Spanish Society of Urgent and Emergency Care. The recommendations are designed to optimise the healthcare challenge presented by the care of patients with acute heart failure in the context of Spain's current National Health System.

  7. Malaria Policy Advisory Committee to the WHO: conclusions and recommendations of eighth biannual meeting (September 2015).

    PubMed

    2016-02-24

    The Malaria Policy Advisory Committee (MPAC) to the World Health Organization held its eighth meeting in Geneva, Switzerland from 16 to 18 September 2015. This article provides a summary of the discussions, conclusions and meeting recommendations. Meeting sessions included: recommendations from the Evidence Review Group (ERG) on mass drug administration; recommendations from the ERG on malaria in pregnancy; recommendations on when to scale back vector control; feedback on the Plasmodium vivax technical brief and the recommendation for G6PD testing before treatment; updates on artemisinin and artemisinin-based combination therapy resistance and the Greater Mekong Subregion elimination strategy; an update from the working group on malaria terminology; and updates on malaria elimination in the World Health Organization European region, the ERG on malaria elimination, and World Health Organization reform to support innovation, efficiency and quality in vector control tools. Policy statements, position statements, and guidelines that arise from the MPAC meeting conclusions and recommendations will be issued formally and disseminated to World Health Organization Member States by the World Health Organization Global Malaria Programme.

  8. Successful Translation of Fluorescence Navigation During Oncologic Surgery: A Consensus Report

    PubMed Central

    Rosenthal, Eben L; Warram, Jason M; de Boer, Esther; Basilion, James P; Biel, Merrill A; Bogyo, Matthew; Bouvet, Michael; Brigman, Brian E; Colson, Yolonda L; DeMeester, Steven R; Gurtner, Geoffrey C; Ishizawa, Takeaki; Jacobs, Paula M; Keereweer, Stijn; Liao, Joseph C; Nguyen, Quyen T; Olson, Jim; Paulsen, Keith D; Rieves, Dwaine; Sumer, Baran D; Tweedle, Michael F; Vahrmeijer, Alexander L; Weichert, Jamey P; Wilson, Brian C; Zenn, Michael R; Zinn, Kurt R; van Dam, Gooitzen M

    2016-01-01

    Navigation with fluorescence guidance is emerging as a promising strategy to improve the efficacy of oncologic surgery in the last decade. The onus is on the surgical community to objectively assess the added value of this technique for routine use daily clinical practice, which will directly impact both the Food and Drug Administration (FDA) approval process and insurance reimbursement. In addition, it is critical to characterize the potential benefits over existing practices and to elucidate both the costs and safety risks. This report is the result a consensus meeting of the American Society of Image Guided Surgery (ASIGS) on February 6th, 2015 at Miami, Florida and reflects a consensus of the participant’s opinions. Our objective is to critically evaluate the platform technology and its optical imaging agents and make recommendations for successful clinical trial development for clinical implementation of this highly promising approach in oncologic surgery. PMID:26449839

  9. The Italian Consensus Conference on Pain in Neurorehabilitation: rationale and methodology

    PubMed Central

    Tamburin, Stefano; Paolucci, Stefano; Magrinelli, Francesca; Musicco, Massimo; Sandrini, Giorgio

    2016-01-01

    Pain is very common in the neurorehabilitation setting, where it may not only represent a target for treatment but can also negatively influence rehabilitation procedures directly or through the side effects of painkillers. To date, there are neither guidelines nor