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Clinical disease guidelines

Saurav Ghimire, Kenneth Lee, Matthew D Jose, Ronald L Castelino, Syed Tabish R Zaidi
AIMS AND OBJECTIVES: To explore clinician assessment of patient adherence, and identify strategies to improve adherence assessment practices in haemodialysis settings. BACKGROUND: Patients with chronic kidney disease undergoing haemodialysis are typically prescribed complex regimens; as such, they are at high risk of medication nonadherence. Current clinical practices focus on prescribing medications, however, little attention is paid to measuring and ensuring patient adherence to their prescribed treatments...
February 20, 2019: Journal of Clinical Nursing
Martina Ventura, Valeria Belleudi, Paolo Sciattella, Riccardo Di Domenicantonio, Mirko Di Martino, Nera Agabiti, Marina Davoli, Danilo Fusco
BACKGROUND: The relationship between guideline adherence and outcomes in patients with acute myocardial infarction (AMI) has been widely investigated considering the emergency, acute, post-acute phases separately, but the effectiveness of the whole care process is not known. AIM: The study aim was to evaluate the effect of the multicomponent continuum of care on 1-year survival after AMI. METHODS: We conducted a cohort study selecting all incident cases of AMI from health information systems during 2011-2014 in the Lazio region...
2019: PloS One
Jose F Figueroa, Daniel M Blumenthal, Yevgeniy Feyman, Austin B Frakt, Alexander Turchin, Gheorghe Doros, Qi Gao, Yang Song, Karen E Joynt Maddox
Importance: One-third of Medicare beneficiaries are enrolled in Medicare Advantage (MA), Medicare's private plan option. Medicare Advantage incentivizes performance on evidence-based care, but limited information exists using reliable clinical data to determine whether this translates into better quality for patients with coronary artery disease (CAD) enrolled in MA compared with those enrolled in traditional fee-for-service (FFS) Medicare. Objective: To determine differences in evidence-based secondary prevention treatments and intermediate outcomes among patients with CAD enrolled in MA vs FFS Medicare...
February 20, 2019: JAMA Cardiology
A Valero, J Olaguibel, J Delgado, V Plaza, F Álvarez, J Molina, E Mascarós, S Quirce
Asthma is one of the most common inflammatory diseases in the world. The main goal of treatment is to achieve optimal control. Although every patient is different, clinical practice guidelines can help physicians to manage the disease. However, the recommendations made by guidelines are not always identical, and the continuous release of new data on the various management strategies can mislead both patients and physicians. We aim to summarize the main controversies in management and treatment recommendations in asthma guidelines, revise the most recent scientific evidence, and pinpoint possible solutions...
February 2019: Journal of Investigational Allergology & Clinical Immunology
Sarah Gregory, Karen Jenkins
BACKGROUND: Caring for patients with diabetes undergoing dialysis often proves challenging for staff working in haemodialysis units as they are not experts in diabetes and unfamiliar with insulin dosing regimens and the impact dialysis can have on blood sugar levels and lifestyle adjustment. There is a need to improve the knowledge base of renal healthcare professionals to better understand the physiology of diabetes, its relationship with end stage kidney disease, and potential changes that can take place when commencing dialysis...
March 2019: Journal of Renal Care
Akiyoshi Nakayama, Hirotaka Matsuo, Akira Ohtahara, Kazuhide Ogino, Masayuki Hakoda, Toshihiro Hamada, Makoto Hosoyamada, Satoshi Yamaguchi, Ichiro Hisatome, Kimiyoshi Ichida, Nariyoshi Shinomiya
Renal hypouricemia (RHUC) is a disease caused by dysfunction of renal urate reabsorption transporters; however, diagnostic guidance and guidelines for RHUC have been lacking, partly due to the low evidence level of studies on RHUC. This review describes a world-first clinical practice guideline (CPG) and its first version in English for this condition. It was developed following the "MINDS Manual for Guideline Development" methodology, which prioritizes evidence-based medicine. It was published in Japanese in 2017 and later translated into English...
February 19, 2019: Human Cell
Morihiro Matsuda, Akiko Kada, Akiko M Saito, Koji Hasegawa
INTRODUCTION: To detect patients at high risk of developing myocardial infarction, plaque characteristics as well as the degree of stenosis in coronary arteries should be evaluated. However, unstable plaque or severe calcification detected via coronary artery CT (CACT) is not reflected in risk stratification according to current guidelines. It is hypothesised that patients with high-risk findings on CACT (even those without proven history of coronary artery diseases; CAD) should be strictly managed to lower their low-density lipoprotein cholesterol (LDL-C) levels to targets of secondary prevention...
January 25, 2019: BMJ Open
(no author information available yet)
No abstract text is available yet for this article.
February 2019: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
May El Hachem, Damiano Abeni, Andrea Diociaiuti, Roberta Rotunno, Francesco Gesualdo, Giovanna Zambruno, Christine Bodermer
BACKGROUND: Inherited ichthyoses are rare disorders characterized by generalized skin scaling. Among them, autosomal recessive congenital ichthyoses (ARCI) form a major subgroup presenting lifelong and severely disabling cutaneous and extracutaneous features and symptoms for which no curative treatment is available. Management relies on daily time-consuming and distressing topical medications. Disease manifestations, symptoms, and daily care affect not only the patient self-perception, but also different dimensions of patient and family life...
February 19, 2019: Italian Journal of Pediatrics
Paula Andrea Cabrera, Rodrigo Pardo
BACKGROUND: In the last decade, efforts have been made in Latin America and the Caribbean to advance in the methodological development of evidence based clinical practice guidelines, among other strategies to improve the health provision of services and indicators. OBJECTIVES: To build an evidence map to show the regional GRADE impact in developing clinical practice guidelines and contrast the results with current needs. METHODS: A systematic literature search was conducted in databases, developer's websites, health ministries, repositories and grey literature...
February 19, 2019: Globalization and Health
Vered Kaufman-Shriqui, Hagit Salem, Ruth Birk, Mona Boaz
BACKGROUND: Dietitians and other health care professionals must be able to translate findings from clinical trials into best treatment practices, a skill termed "knowledge translation". This skill requires knowledge of treatment guidelines as well as the science underpinning treatment recommendations. Unsatisfactory knowledge translation of medical nutrition therapy (MNT) has been documented. METHODS: Individuals registered to attend a leading national nutrition conference were asked to participate in an online cross-sectional survey...
February 13, 2019: Nutrients
Rachel Barish, Filipa Lynce, Keith Unger, Ana Barac
Cardio-oncology is a rapidly developing field which seeks to improve patient outcomes through enhanced clinical and research collaboration across the disciplines of oncology and cardiology. Breast cancer (BC) is the most common cancer diagnosis among women in the United States and, as decades of research have resulted in decreased mortality rates, there has been an increasing focus on reducing short- and long-term treatment toxicity and improving morbidity among survivors. Preexisting or emergent cardiovascular disease in a patient with BC requires a multidisciplinary, team-based approach to balance the need for curative cancer treatment while preventing increased cardiovascular disease morbidity and mortality...
February 19, 2019: Circulation
Sonia M Grandi, Kristian B Filion, Sarah Yoon, Henok T Ayele, Carla M Doyle, Jennifer A Hutcheon, Graeme N Smith, Genevieve C Gore, Joel G Ray, Kara Nerenberg, Robert W Platt
BACKGROUND: Women with a history of certain pregnancy complications are at higher risk for cardiovascular (CVD) disease. However, most clinical guidelines only recommend postpartum follow-up of those with a history of preeclampsia, gestational diabetes mellitus, or preterm birth. This systematic review was undertaken to determine if there is an association between a broader array of pregnancy complications and the future risk of CVD. METHODS: We systematically searched PubMed, MEDLINE and EMBASE (via Ovid), CINAHL, and the Cochrane Library from inception to September 22, 2017, for observational studies of the association between the hypertensive disorders of pregnancy, placental abruption, preterm birth, gestational diabetes mellitus, low birth weight, small-for-gestational-age birth, stillbirth, and miscarriage and subsequent CVD...
February 19, 2019: Circulation
Marco Rossi, Giuseppe Casale, Danilo Badiali, Federica Aielli, Maria Antonietta Aloe Spiriti, Roberto Arcioni, Francesca Bordin, Maurizio Ferrara, Gloria Morelli Sbarra, Antonio Corcione, Franco Marinangeli, Paolo Marchetti
Constipation, one of the adverse effects of opioid therapy with a major impact on quality of life, is still an unmet need for cancer patients, particularly those with an advanced and progressive disease, and for non-cancer patients chronically treated with opioids. The awareness of this condition is poor among healthcare providers, despite the recent publication of guidelines and consensus conferences. An early multidisciplinary approach of opioid-induced bowel dysfunction (OIBD), based on available therapies of proven effectiveness, could support clinicians in managing this condition, thus increasing patients' adherence to pain therapy...
February 18, 2019: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
C Lehmann, J Malin, I Suárez, G Fätkenheuer
Human immunodeficiency virus (HIV) infection has become a chronic disease with a favourable prognosis if adequate antiretroviral therapy (ART) is applied. Therefore, each patient with HIV infection should be treated irrespectively of clinical symptoms or of immunological status. A combination of three active drugs that have to be taken life-long has been standard for many years. The regimen contains two nucleoside reverse transcriptase inhibitors plus either an integrase inhibitor, a boosted protease inhibitor, or a non-nucleoside reverse transcriptase inhibitor...
February 18, 2019: Der Internist
Haley Clark, Fred Cao, Carson Leong, Eric Berthelet
INTRODUCTION: Patients requiring treatment for second cancer incidences present unique radiotherapy plan development challenges. Historical dose delivered to organs at risk must be accounted for to properly estimate lifetime toxicity risks, but historical dose delivered to the region now occupied by tumours does not contribute to the prescription dose. Treatment planning systems permit inclusion of a base plan but do not provide the ability to manipulate it. We present a technique, dose cropping, which incorporates organ-at-risk dose history into the base plan while selectively excising dose history to diseased tissues now occupied by tumours...
March 2019: Journal of Medical Imaging and Radiation Sciences
Jo-Anne Manski-Nankervis, Sharmala Thuraisingam, Janet K Sluggett, Gary Kilov, John Furler, David O'Neal, Alicia Jenkins
BACKGROUND: Previous studies in general practice and hospital settings have identified that prescribing of non-insulin diabetes medications may be sub-optimal in people with type 2 diabetes (T2D) and renal impairment. Since these publications, a number of new medications have become available for the management of T2D. Study aims were to, in a cohort of Australians with T2D and renal impairment attending general practice, (1) investigate whether the prescribing of non-insulin diabetes medications is consistent with dosing adjustments recommended within current Australian Diabetes Society (ADS) guidelines; and (2) identify patient socio-demographic and clinical factors associated with at least one prescription of a non-insulin diabetes medication inconsistent with current ADS guidelines for medication doses...
February 18, 2019: BMC Family Practice
Sara Del Magno, Federico Fracassi, Guy C M Grinwis, Luciana Mandrioli, Gualtiero Gandini, Federica Rossi, Rubina Sirri, Luciano Pisoni, Marianna A Tryfonidou, Björn P Meij
No standardized treatment guidelines are reported in veterinary medicine for dogs with large pituitary corticotroph neoplasms causing neurological signs, and such dogs usually have a short overall survival. When these dogs undergo pituitary surgery and the tumor regrows there are few reports of subsequent treatments. A 7 yr old male Maltese diagnosed with pituitary-dependent hypercortisolism developed seizures in conjunction with a large pituitary corticotroph adenoma and underwent transsphenoidal hypophysectomy...
March 2019: Journal of the American Animal Hospital Association
Caroline de Godoi Rezende Costa Molino, Nathalia Celini Leite-Santos, Franciele Cordeiro Gabriel, Sheila Kalb Wainberg, Luciana Pereira de Vasconcelos, Rafael Augusto Mantovani-Silva, Eliane Ribeiro, Nicolina Silvana Romano-Lieber, Airton Tetelbom Stein, Daniela Oliveira de Melo
Importance: As the rate of publication of new and sometimes conflicting medical research increases, clinicians rely heavily on clinical practice guidelines (CPGs) to inform practice. However, CPGs are of widely variable quality, and there are no existing objective measures to rate the quality of CPGs. Objective: To systematically assess 421 CPGs for the management of common noncommunicable diseases in primary care using the validated Appraisal of Guidelines for Research and Evaluation Instrument, version II (AGREE-II) tool and elucidate the factors associated with quality of CPGs...
February 18, 2019: JAMA Internal Medicine
Shanlee M Davis, Mitchell E Geffner
Individuals with Turner syndrome (TS) have a higher morbidity and mortality compared to the general population. Diabetes and cardiovascular disease are the major contributors to this burden. Precursors to diabetes and cardiovascular disease make up what is known as metabolic syndrome, including abdominal obesity, hypertension, dyslipidemia, and elevated fasting glucose. These features of poor cardiometabolic health are also prevalent among women with TS. Youth with TS also exhibit many of these features, indicating that the pathogenesis of these cardiometabolic conditions may begin early in life...
February 18, 2019: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
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