This document summarizes guidelines from the Japanese Society of Pediatric Cardiology and Cardiac Surgery for the medical treatment of acute Kawasaki disease. It discusses the purpose of treatment guidelines, evidence classification systems, and background on revising previous guidelines. The primary treatment for acute Kawasaki disease is intravenous immunoglobulin (IVIG) to reduce risks of coronary artery abnormalities. For patients resistant to first-line IVIG treatment, second-line options include additional IVIG, steroids, infliximab, cyclosporin A, and methotrexate, though evidence is limited. Risk stratification models may help determine initial combination treatment for high-risk patients.
This study analyzed data from Sweden's first national patient surveys conducted between 2009-2010 with over 232,000 respondents across primary care, outpatient care, inpatient hospital care, and emergency care. The surveys assessed patient perceptions of care quality based on indicators of patient-centeredness.
Results showed high satisfaction (81-96%) with respectful treatment but lower satisfaction on other indicators like being informed of possible warning signs (25-30% satisfied) or feeling involved in care planning (21-42% satisfied). Regression analysis found that women, those without Swedish as their mother tongue, and those with more education expressed lower satisfaction on several indicators compared to men, Swedish mother tongue patients, and those with less education, respectively.
International consensus recommendations on the management of 2010Klauditha AC
This document provides an update to international consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding (UGIB). A multidisciplinary group of 34 experts developed the recommendations using a standardized process. Key recommendations include:
1) Early risk stratification of patients using validated prognostic scales to identify high-risk cases requiring intervention.
2) Performing early endoscopy (within 24 hours) for risk assessment and therapeutic purposes.
3) Using endoscopic hemostasis for high-risk lesions while considering attempts to dislodge clots for underlying stigmata using pharmacological or combination treatments.
This document provides guidelines for managing hyperglycemia in type 2 diabetes using a patient-centered approach from the American Diabetes Association and European Association for the Study of Diabetes. It summarizes that intensive glycemic control can reduce microvascular complications but may increase mortality risk. The guidelines emphasize individualizing treatment based on patient preferences, needs, and tolerances. A patient-centered approach engages patients in medical decisions to improve adherence and outcomes for their chronic condition.
This document provides a position statement from the American Diabetes Association and European Association for the Study of Diabetes on the management of hyperglycemia in type 2 diabetes. It recommends a patient-centered approach to treatment that considers individual patient needs, preferences, and tolerances. The statement reviews the evidence on glycemic control and outcomes, discusses the increasing complexity of treatment options, and emphasizes the importance of shared decision making between clinicians and patients.
Journal Club presentation on Hypertension StudyKunal Modak
This study assessed the prevalence and risk factors of hypertension among 192 bank employees in Puducherry, India. The prevalence of hypertension was found to be 44.3%, with 55% being previously known cases and 45% newly diagnosed. Risk factors found to be significantly associated with hypertension included older age (over 40), alcohol use, adding extra salt while eating, and less physical activity of under 2 hours per week. The study provides valuable information on the risk factors for hypertension among this occupational group.
This document summarizes a journal club presentation on a study assessing the knowledge and practices of intensive care nurses regarding the prevention of ventilator-associated pneumonia. The study found that the nurses had average knowledge but unsatisfactory practices in preventing VAP. It concluded that additional in-service education and training programs are needed to improve nurses' knowledge and practices and reduce infections among patients. The presentation reviewed the objectives, methods, findings and conclusions of the descriptive study conducted with 50 nurses in India. It also discussed relevant literature supporting the average knowledge levels found and the need for preventative protocols and guidelines.
The 2012 AHS/AAN Guidelines for Prevention of Episodic Migraine: A Summary an...Utai Sukviwatsirikul
The 2012 AHS/AAN Guidelines for Prevention of Episodic Migraine: A Summary and Comparison With Other Recent Clinical Practice Guidelineshead_2185 930..945
Elizabeth Loder, MD, MPH; Rebecca Burch, MD; Paul Rizzoli, MD
REG ACOS Working Group Meeting 25/09/15Zoe Mitchell
The document outlines plans for a proof of concept study to estimate the prevalence of Asthma-COPD Overlap Syndrome (ACOS) using different population datasets and case definitions. It describes four population groups - COPD diagnosis, ACOS diagnosis, asthma diagnosis, and no diagnosis of asthma or COPD - that will be analyzed in eight available databases to compare ACOS prevalence between definitions. The Optimum Patient Care Research Database pilot data will also be used as a case study to categorize patients as COPD, asthma, or ACOS based on coded consultation reasons to identify overlap between the conditions.
This study analyzed data from Sweden's first national patient surveys conducted between 2009-2010 with over 232,000 respondents across primary care, outpatient care, inpatient hospital care, and emergency care. The surveys assessed patient perceptions of care quality based on indicators of patient-centeredness.
Results showed high satisfaction (81-96%) with respectful treatment but lower satisfaction on other indicators like being informed of possible warning signs (25-30% satisfied) or feeling involved in care planning (21-42% satisfied). Regression analysis found that women, those without Swedish as their mother tongue, and those with more education expressed lower satisfaction on several indicators compared to men, Swedish mother tongue patients, and those with less education, respectively.
International consensus recommendations on the management of 2010Klauditha AC
This document provides an update to international consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding (UGIB). A multidisciplinary group of 34 experts developed the recommendations using a standardized process. Key recommendations include:
1) Early risk stratification of patients using validated prognostic scales to identify high-risk cases requiring intervention.
2) Performing early endoscopy (within 24 hours) for risk assessment and therapeutic purposes.
3) Using endoscopic hemostasis for high-risk lesions while considering attempts to dislodge clots for underlying stigmata using pharmacological or combination treatments.
This document provides guidelines for managing hyperglycemia in type 2 diabetes using a patient-centered approach from the American Diabetes Association and European Association for the Study of Diabetes. It summarizes that intensive glycemic control can reduce microvascular complications but may increase mortality risk. The guidelines emphasize individualizing treatment based on patient preferences, needs, and tolerances. A patient-centered approach engages patients in medical decisions to improve adherence and outcomes for their chronic condition.
This document provides a position statement from the American Diabetes Association and European Association for the Study of Diabetes on the management of hyperglycemia in type 2 diabetes. It recommends a patient-centered approach to treatment that considers individual patient needs, preferences, and tolerances. The statement reviews the evidence on glycemic control and outcomes, discusses the increasing complexity of treatment options, and emphasizes the importance of shared decision making between clinicians and patients.
Journal Club presentation on Hypertension StudyKunal Modak
This study assessed the prevalence and risk factors of hypertension among 192 bank employees in Puducherry, India. The prevalence of hypertension was found to be 44.3%, with 55% being previously known cases and 45% newly diagnosed. Risk factors found to be significantly associated with hypertension included older age (over 40), alcohol use, adding extra salt while eating, and less physical activity of under 2 hours per week. The study provides valuable information on the risk factors for hypertension among this occupational group.
This document summarizes a journal club presentation on a study assessing the knowledge and practices of intensive care nurses regarding the prevention of ventilator-associated pneumonia. The study found that the nurses had average knowledge but unsatisfactory practices in preventing VAP. It concluded that additional in-service education and training programs are needed to improve nurses' knowledge and practices and reduce infections among patients. The presentation reviewed the objectives, methods, findings and conclusions of the descriptive study conducted with 50 nurses in India. It also discussed relevant literature supporting the average knowledge levels found and the need for preventative protocols and guidelines.
The 2012 AHS/AAN Guidelines for Prevention of Episodic Migraine: A Summary an...Utai Sukviwatsirikul
The 2012 AHS/AAN Guidelines for Prevention of Episodic Migraine: A Summary and Comparison With Other Recent Clinical Practice Guidelineshead_2185 930..945
Elizabeth Loder, MD, MPH; Rebecca Burch, MD; Paul Rizzoli, MD
REG ACOS Working Group Meeting 25/09/15Zoe Mitchell
The document outlines plans for a proof of concept study to estimate the prevalence of Asthma-COPD Overlap Syndrome (ACOS) using different population datasets and case definitions. It describes four population groups - COPD diagnosis, ACOS diagnosis, asthma diagnosis, and no diagnosis of asthma or COPD - that will be analyzed in eight available databases to compare ACOS prevalence between definitions. The Optimum Patient Care Research Database pilot data will also be used as a case study to categorize patients as COPD, asthma, or ACOS based on coded consultation reasons to identify overlap between the conditions.
Homeopathic medical practice: Long-term results of a cohort study with 3981 p...home
Disease severity and quality of life demonstrated marked and sustained
improvements following homeopathic treatment period. Our findings indicate that homeopathic
medical therapy may play a beneficial role in the long-term care of patients with chronic diseases.
Diabetes health profile e book development & applications 2015 v.2Keith Meadows
The document provides an overview of the Diabetes Health Profile (DHP), a patient-reported outcome measure for assessing the psychological and behavioral impact of living with diabetes. It describes the development of the DHP based on interviews with patients and clinicians. The DHP measures psychological distress, barriers to activity, and disinhibited eating. It has been validated and used in various clinical trials, studies, and surveys involving over 10,000 people with diabetes to evaluate outcomes. The DHP is available in nearly 30 languages and its use is supported by manuals, norms, and score visualization tools.
Evidence-based medicine (EBM) involves using the best available evidence from systematic research to inform clinical decision-making. It has its origins in the mid-19th century with emphasis on collecting data from patient experiences. Key milestones included the development of randomized controlled trials in the 1940s-50s and emphasis on using evidence from such trials to guide clinical practice. EBM is now the standard for evaluating treatments and making recommendations, though traditional experience and expertise remain important.
This document discusses evidence-based laboratory medicine and the need to support clinical decision-making with robust evidence. It notes that while laboratory medicine is perceived as scientific, evidence for many diagnostic tests is limited or flawed. An evidence-based approach can help improve education, guidelines, decision-making and resource allocation. The challenges include a lack of evidence demonstrating the impact of diagnostic tests on patient outcomes. Health technology assessment and outcomes research are important tools to develop high-quality evidence and address the current pressures on healthcare systems.
Effect of nursing intervention on clinical outcomes and patient satisfaction ...Alexander Decker
1) The study aimed to determine the effect of nursing intervention on clinical outcomes and patient satisfaction among patients with upper gastrointestinal bleeding.
2) A quasi-experimental study was conducted on 50 patients divided into a study group that received nursing intervention and a control group.
3) Statistically significant differences were found between the groups in clinical outcomes like bleeding, vital signs, and lab tests as well as higher patient satisfaction scores in the study group compared to the control group, showing that nursing intervention improved patients' outcomes and satisfaction.
Determine the Patients' Satisfaction Concerning In-hospital Information Progr...iosrjce
The document describes a study that aimed to determine patients' satisfaction with an in-hospital information program for coronary artery disease. Sixty patients were divided into a study group that received the information program and a control group. The study group showed improved satisfaction with health status, medication, lifestyle, diet and post-attack information compared to the control group. The results indicate that patient satisfaction is related to nurse quality of care, which improved more for the study group than the control group after the program. The study concluded that patients generally lack sufficient in-hospital information and recommended establishing standardized education programs and rehabilitation centers.
Homeopathic treatment of patients with chronic sinusitis: A prospective obser...home
This observational study showed relevant improvements that persisted for 8 years
in patients seeking homeopathic treatment because of sinusitis. The extent to which the observed
effects are due to the life-style regulation and placebo or context effects associated with the
treatment needs clarification in future explanatory studies.
Corticosteroids for sore throat sr ma bmj 2018Mayra Serrano
This systematic review and meta-analysis found that a single low dose of corticosteroids, such as oral dexamethasone up to 10 mg, provides moderate to high quality evidence of pain relief for patients with sore throat. Patients who received corticosteroids were twice as likely to experience pain relief after 24 hours and 1.5 times more likely to have no pain at 48 hours, with no increase in serious adverse effects. The mean time to complete pain resolution was about 11 hours shorter with corticosteroids. Included trials enrolled over 1400 individuals and assessed outcomes up to 48 hours, but did not evaluate risks of repeated corticosteroid use for recurrent sore throats.
Journal Club route to Evidence Based MedicineCSN Vittal
The document discusses evidence-based medicine and journal clubs. It begins by outlining how doctors historically practiced medicine with little reading, then introduces evidence-based medicine as a better approach. Evidence-based medicine involves forming questions based on patients, current evidence, and clinical expertise. The document then discusses how journal clubs can be used to critically appraise recent studies and apply the evidence to patient care, improving quality. Journal clubs follow the steps of evidence-based medicine by posing questions, searching literature, and critically evaluating evidence to inform clinical decisions.
SLC CME- Evidence based medicine 07/27/2007cddirks
Saint Luke's Care, a quality improvement organization within Saint Luke's Health System, presents a CME presentation by Dr. Brent Beasley on Evidence Based Medical Care.
Obstetrics and gynecology outpatient scenario of an Indian homeopathic hospit...home
This study aimed to document homeopathic prescriptions and clinical outcomes in an obstetrics and gynecology outpatient setting in India over 3 months. Data were collected on 429 patients with 434 medical conditions. The most common conditions treated were leucorrhea, irregular menses, dysmenorrhea, menorrhagia, and hypomenorrhea. Overall, 61% of outcomes were positive, 20.8% negative, and 18.2% showed no change. Strongly positive outcomes were seen most often for oligomenorrhea, leucorrhea, polycystic ovary, dysmenorrhea, and irregular menses. Individualized homeopathic medicines were prescribed in 95.6%
This document summarizes a randomized controlled trial that investigated whether stable patients with infective endocarditis could be safely treated with oral antibiotics rather than continued intravenous antibiotics. The trial involved 400 patients across multiple centers in Denmark who had infective endocarditis of the left heart caused by common bacterial species. Patients received either continued intravenous antibiotics according to guidelines or a partial oral antibiotic treatment regimen. The primary outcome was to show non-inferiority of oral treatment. Results showed that oral antibiotic treatment was found to be non-inferior to continued intravenous treatment for stable patients.
1. The document discusses the roles of biomedical scientists in disease detection and management through various tests and investigations. It covers topics like whole population screening, disease diagnosis, monitoring, and discusses tests in pathology disciplines like immunopathology and hematology.
2. It also discusses non-biomedical investigations like blood pressure measurement, electromyography, and magnetic resonance imaging.
3. Specifically, it discusses myocardial infarction - the signs and symptoms are analyzed using electrocardiograms, blood tests to detect cardiac troponin, and other biomarkers to confirm the diagnosis.
European clinical practice guideline on diagnosis hiponatremiaJaime dehais
1. Hyponatraemia, defined as a serum sodium concentration less than 135 mmol/l, is common in clinical practice and associated with increased mortality, morbidity, and length of hospital stay.
2. Despite this, management of patients with hyponatraemia remains problematic due to diverse approaches across institutions and specialties.
3. The European Society of Intensive Care Medicine, European Society of Endocrinology, and European Renal Association developed this joint clinical practice guideline to provide a standardized approach to diagnosis and treatment of hyponatraemia.
This study evaluated the feasibility and usefulness of geriatric screening and assessment in older cancer patients. Researchers prospectively studied 1,967 patients aged 70+ from 10 Belgian hospitals. They found that geriatric screening detected previously unknown geriatric problems in over half of patients. When physicians were aware of screening results, it led to geriatric interventions in 26% of patients and influenced treatment decisions in 25% of patients. The study demonstrates that large-scale geriatric screening and assessment can significantly impact cancer care for older adults.
Referral For Invasive Procedures For Cancer Pain Dr Alison Mitchellepicyclops
Lecture given to the North British Pain Association on 16th May 2008 by Dr Alison Mitchell. In this talk, Dr Mitchell discusses the indications for referral of patients with cancer pain for invasive procedures. She describes the new interventional cancer pain service being set up in Glasgow. www.nbpa.org.uk
The document provides an overview of evidence-based medicine, including what it is, why it is important, where evidence comes from, levels of evidence, and the steps to practice evidence-based medicine. It discusses formulating a clear clinical question, searching for relevant information and studies, critically appraising the evidence, and applying the evidence to a specific patient case. Key aspects covered include evaluating the validity, importance, and applicability of various types of studies to determine the strength and relevance of the evidence. The goal is to systematically review and apply the best available research findings to clinical decision making.
1. The study compared the effects of a 12-week team-based learning (TBL) diabetes education intervention versus traditional lecture-based education on patient outcomes. 57 patients were randomized into either the TBL or control group.
2. While both groups showed improvements in clinical markers and knowledge over time, the TBL group showed a significant difference in A1C levels compared to the control group at 6 months. The TBL group also showed significant improvements in systolic blood pressure and self-efficacy.
3. Overall, the study found that TBL patient education led to better retention of diabetes knowledge and some improved clinical outcomes compared to traditional lecture-based education, suggesting TBL is a useful approach for diabetes
This article summarizes the results of establishing care pathways and an expert patient program for chronic conditions like diabetes, heart failure, and COPD in Barcelona, Spain. Key results include:
- Increased detection and monitoring of the conditions through improved protocols between primary and specialized care.
- Reduced hospital admissions and length of stay for heart failure patients.
- Increased patient knowledge and self-care through the expert patient program, which may have contributed to reduced heart failure admissions.
- High satisfaction among patients in the expert patient program.
This document describes a study that developed and validated a treatment algorithm and patient information toolkit for managing uremic pruritus (UP) in patients with chronic kidney disease and end-stage kidney disease. The algorithm and tools were created through a literature review and expert input from clinicians. The algorithm and tools then underwent three rounds of validation where clinicians rated their content validity and face validity. The results found high content validity (average CVI of 0.89) and face validity (over 78% of clinicians agreeing or strongly agreeing) for the algorithm. A similar validation process for the patient information tools also found high content validity and face validity. This validation establishes that the developed treatment algorithm and patient information toolkit are relevant and useful according to expert
The document presents recommendations from the American College of Rheumatology (ACR) for the treatment of juvenile idiopathic arthritis (JIA). It describes the process used to develop the recommendations, which involved a systematic review of the literature and application of the RAND/UCLA Appropriateness Method. This method utilizes a Core Expert Panel and Task Force Panel to rate treatment scenarios and develop consensus recommendations. The recommendations cover initiation and safety monitoring of medications for JIA, including NSAIDs, injections, DMARDs, biologics, and steroids. They are intended to guide but not dictate treatment decisions for individual patients.
Homeopathic medical practice: Long-term results of a cohort study with 3981 p...home
Disease severity and quality of life demonstrated marked and sustained
improvements following homeopathic treatment period. Our findings indicate that homeopathic
medical therapy may play a beneficial role in the long-term care of patients with chronic diseases.
Diabetes health profile e book development & applications 2015 v.2Keith Meadows
The document provides an overview of the Diabetes Health Profile (DHP), a patient-reported outcome measure for assessing the psychological and behavioral impact of living with diabetes. It describes the development of the DHP based on interviews with patients and clinicians. The DHP measures psychological distress, barriers to activity, and disinhibited eating. It has been validated and used in various clinical trials, studies, and surveys involving over 10,000 people with diabetes to evaluate outcomes. The DHP is available in nearly 30 languages and its use is supported by manuals, norms, and score visualization tools.
Evidence-based medicine (EBM) involves using the best available evidence from systematic research to inform clinical decision-making. It has its origins in the mid-19th century with emphasis on collecting data from patient experiences. Key milestones included the development of randomized controlled trials in the 1940s-50s and emphasis on using evidence from such trials to guide clinical practice. EBM is now the standard for evaluating treatments and making recommendations, though traditional experience and expertise remain important.
This document discusses evidence-based laboratory medicine and the need to support clinical decision-making with robust evidence. It notes that while laboratory medicine is perceived as scientific, evidence for many diagnostic tests is limited or flawed. An evidence-based approach can help improve education, guidelines, decision-making and resource allocation. The challenges include a lack of evidence demonstrating the impact of diagnostic tests on patient outcomes. Health technology assessment and outcomes research are important tools to develop high-quality evidence and address the current pressures on healthcare systems.
Effect of nursing intervention on clinical outcomes and patient satisfaction ...Alexander Decker
1) The study aimed to determine the effect of nursing intervention on clinical outcomes and patient satisfaction among patients with upper gastrointestinal bleeding.
2) A quasi-experimental study was conducted on 50 patients divided into a study group that received nursing intervention and a control group.
3) Statistically significant differences were found between the groups in clinical outcomes like bleeding, vital signs, and lab tests as well as higher patient satisfaction scores in the study group compared to the control group, showing that nursing intervention improved patients' outcomes and satisfaction.
Determine the Patients' Satisfaction Concerning In-hospital Information Progr...iosrjce
The document describes a study that aimed to determine patients' satisfaction with an in-hospital information program for coronary artery disease. Sixty patients were divided into a study group that received the information program and a control group. The study group showed improved satisfaction with health status, medication, lifestyle, diet and post-attack information compared to the control group. The results indicate that patient satisfaction is related to nurse quality of care, which improved more for the study group than the control group after the program. The study concluded that patients generally lack sufficient in-hospital information and recommended establishing standardized education programs and rehabilitation centers.
Homeopathic treatment of patients with chronic sinusitis: A prospective obser...home
This observational study showed relevant improvements that persisted for 8 years
in patients seeking homeopathic treatment because of sinusitis. The extent to which the observed
effects are due to the life-style regulation and placebo or context effects associated with the
treatment needs clarification in future explanatory studies.
Corticosteroids for sore throat sr ma bmj 2018Mayra Serrano
This systematic review and meta-analysis found that a single low dose of corticosteroids, such as oral dexamethasone up to 10 mg, provides moderate to high quality evidence of pain relief for patients with sore throat. Patients who received corticosteroids were twice as likely to experience pain relief after 24 hours and 1.5 times more likely to have no pain at 48 hours, with no increase in serious adverse effects. The mean time to complete pain resolution was about 11 hours shorter with corticosteroids. Included trials enrolled over 1400 individuals and assessed outcomes up to 48 hours, but did not evaluate risks of repeated corticosteroid use for recurrent sore throats.
Journal Club route to Evidence Based MedicineCSN Vittal
The document discusses evidence-based medicine and journal clubs. It begins by outlining how doctors historically practiced medicine with little reading, then introduces evidence-based medicine as a better approach. Evidence-based medicine involves forming questions based on patients, current evidence, and clinical expertise. The document then discusses how journal clubs can be used to critically appraise recent studies and apply the evidence to patient care, improving quality. Journal clubs follow the steps of evidence-based medicine by posing questions, searching literature, and critically evaluating evidence to inform clinical decisions.
SLC CME- Evidence based medicine 07/27/2007cddirks
Saint Luke's Care, a quality improvement organization within Saint Luke's Health System, presents a CME presentation by Dr. Brent Beasley on Evidence Based Medical Care.
Obstetrics and gynecology outpatient scenario of an Indian homeopathic hospit...home
This study aimed to document homeopathic prescriptions and clinical outcomes in an obstetrics and gynecology outpatient setting in India over 3 months. Data were collected on 429 patients with 434 medical conditions. The most common conditions treated were leucorrhea, irregular menses, dysmenorrhea, menorrhagia, and hypomenorrhea. Overall, 61% of outcomes were positive, 20.8% negative, and 18.2% showed no change. Strongly positive outcomes were seen most often for oligomenorrhea, leucorrhea, polycystic ovary, dysmenorrhea, and irregular menses. Individualized homeopathic medicines were prescribed in 95.6%
This document summarizes a randomized controlled trial that investigated whether stable patients with infective endocarditis could be safely treated with oral antibiotics rather than continued intravenous antibiotics. The trial involved 400 patients across multiple centers in Denmark who had infective endocarditis of the left heart caused by common bacterial species. Patients received either continued intravenous antibiotics according to guidelines or a partial oral antibiotic treatment regimen. The primary outcome was to show non-inferiority of oral treatment. Results showed that oral antibiotic treatment was found to be non-inferior to continued intravenous treatment for stable patients.
1. The document discusses the roles of biomedical scientists in disease detection and management through various tests and investigations. It covers topics like whole population screening, disease diagnosis, monitoring, and discusses tests in pathology disciplines like immunopathology and hematology.
2. It also discusses non-biomedical investigations like blood pressure measurement, electromyography, and magnetic resonance imaging.
3. Specifically, it discusses myocardial infarction - the signs and symptoms are analyzed using electrocardiograms, blood tests to detect cardiac troponin, and other biomarkers to confirm the diagnosis.
European clinical practice guideline on diagnosis hiponatremiaJaime dehais
1. Hyponatraemia, defined as a serum sodium concentration less than 135 mmol/l, is common in clinical practice and associated with increased mortality, morbidity, and length of hospital stay.
2. Despite this, management of patients with hyponatraemia remains problematic due to diverse approaches across institutions and specialties.
3. The European Society of Intensive Care Medicine, European Society of Endocrinology, and European Renal Association developed this joint clinical practice guideline to provide a standardized approach to diagnosis and treatment of hyponatraemia.
This study evaluated the feasibility and usefulness of geriatric screening and assessment in older cancer patients. Researchers prospectively studied 1,967 patients aged 70+ from 10 Belgian hospitals. They found that geriatric screening detected previously unknown geriatric problems in over half of patients. When physicians were aware of screening results, it led to geriatric interventions in 26% of patients and influenced treatment decisions in 25% of patients. The study demonstrates that large-scale geriatric screening and assessment can significantly impact cancer care for older adults.
Referral For Invasive Procedures For Cancer Pain Dr Alison Mitchellepicyclops
Lecture given to the North British Pain Association on 16th May 2008 by Dr Alison Mitchell. In this talk, Dr Mitchell discusses the indications for referral of patients with cancer pain for invasive procedures. She describes the new interventional cancer pain service being set up in Glasgow. www.nbpa.org.uk
The document provides an overview of evidence-based medicine, including what it is, why it is important, where evidence comes from, levels of evidence, and the steps to practice evidence-based medicine. It discusses formulating a clear clinical question, searching for relevant information and studies, critically appraising the evidence, and applying the evidence to a specific patient case. Key aspects covered include evaluating the validity, importance, and applicability of various types of studies to determine the strength and relevance of the evidence. The goal is to systematically review and apply the best available research findings to clinical decision making.
1. The study compared the effects of a 12-week team-based learning (TBL) diabetes education intervention versus traditional lecture-based education on patient outcomes. 57 patients were randomized into either the TBL or control group.
2. While both groups showed improvements in clinical markers and knowledge over time, the TBL group showed a significant difference in A1C levels compared to the control group at 6 months. The TBL group also showed significant improvements in systolic blood pressure and self-efficacy.
3. Overall, the study found that TBL patient education led to better retention of diabetes knowledge and some improved clinical outcomes compared to traditional lecture-based education, suggesting TBL is a useful approach for diabetes
This article summarizes the results of establishing care pathways and an expert patient program for chronic conditions like diabetes, heart failure, and COPD in Barcelona, Spain. Key results include:
- Increased detection and monitoring of the conditions through improved protocols between primary and specialized care.
- Reduced hospital admissions and length of stay for heart failure patients.
- Increased patient knowledge and self-care through the expert patient program, which may have contributed to reduced heart failure admissions.
- High satisfaction among patients in the expert patient program.
This document describes a study that developed and validated a treatment algorithm and patient information toolkit for managing uremic pruritus (UP) in patients with chronic kidney disease and end-stage kidney disease. The algorithm and tools were created through a literature review and expert input from clinicians. The algorithm and tools then underwent three rounds of validation where clinicians rated their content validity and face validity. The results found high content validity (average CVI of 0.89) and face validity (over 78% of clinicians agreeing or strongly agreeing) for the algorithm. A similar validation process for the patient information tools also found high content validity and face validity. This validation establishes that the developed treatment algorithm and patient information toolkit are relevant and useful according to expert
The document presents recommendations from the American College of Rheumatology (ACR) for the treatment of juvenile idiopathic arthritis (JIA). It describes the process used to develop the recommendations, which involved a systematic review of the literature and application of the RAND/UCLA Appropriateness Method. This method utilizes a Core Expert Panel and Task Force Panel to rate treatment scenarios and develop consensus recommendations. The recommendations cover initiation and safety monitoring of medications for JIA, including NSAIDs, injections, DMARDs, biologics, and steroids. They are intended to guide but not dictate treatment decisions for individual patients.
This document outlines a prospective study on the effect of pandemic restrictions on quality of life and medication adherence in diabetes patients. It discusses the introduction, aims and objectives, methodology, results and conclusion of the study. The study aims to assess the impact of COVID-19 pandemic restrictions on quality of life and medication adherence in 110 diabetes patients in Bangalore, India over 6 months. Preliminary results show that quality of life was reduced for most patients due to restrictions, while medication adherence decreased initially but increased after counselling. New diabetes cases and complications were also observed due to reduced activity and increased weight during the pandemic. The study concludes that the prevalence of diabetes has increased overall due to pandemic restrictions.
This document provides guidelines for the global management and prevention of asthma. It was revised in 2014 by the Global Initiative for Asthma (GINA) organization. GINA aims to disseminate information about asthma care worldwide and provide an evidence-based framework to improve asthma management. The guidelines are informed by international experts and focus on control-based management of asthma with medications and self-management education.
Using PROs to measure secondary endpointsKeith Meadows
The document discusses the use of patient-reported outcome (PRO) measures to evaluate diabetes treatments. It describes:
1) The importance of selecting primary and secondary endpoints to comprehensively assess treatment effects. Secondary endpoints alone cannot support labeling claims without confirmation from primary endpoints.
2) How to choose appropriate PROs by identifying relevant concepts, developing conceptual frameworks, and selecting generic or condition-specific measures.
3) An example endpoint model and case study using the Diabetes Health Profile-18 PRO measure to evaluate treatments' effects on health-related quality of life and glycemic control. The study found improvements in PRO scores correlated with meeting composite clinical endpoints.
These guidelines provide evidence-based guidance for managing dengue infection in adult patients. They were developed by a multidisciplinary group and reviewed by independent experts. The guidelines aim to improve diagnosis and appropriate care, identify severe cases, provide fluid management guidance, and reduce transmission. Key recommendations include monitoring patients for plasma leakage and bleeding, fluid resuscitation for shock, and blood product transfusion when needed. The guidelines are meant to guide but not replace clinical judgment based on each patient's situation.
The document discusses new guidance from the 2021 Canadian Cardiovascular Society/Canadian Heart Failure Society Heart Failure Guideline Panel. It provides an overview of a webinar series on heart failure that will discuss topics such as screening and diagnosis of HFrEF and HFpEF, device therapy, and non-pharmacological management. The webinars will be presented by experts in the field. The document also provides information on proper use and citation of guideline materials from the CCS for educational or industry programs.
Respirology - 2022 - Barnett - Thoracic Society of Australia and New Zealand ...AssessoriadaGernciaG
This position paper from the Thoracic Society of Australia and New Zealand provides recommendations for acute oxygen use in adults. Key recommendations include:
1) Pulse oximetry should be routinely recorded along with vital signs to assess oxygenation. Arterial blood gases are still the gold standard but have limitations.
2) Oxygen is a drug that requires prescription documenting flow rate, delivery device, oxygen saturation targets, and criteria for deterioration or improvement.
3) The recommended oxygen saturation target range is 88-92% for those with chronic respiratory disease to avoid hypercapnia, and 92-96% for other situations.
4) Nasal cannulae are the preferred delivery method. Humidified
Evaluate of the Physical Performance of Patients Undergoing HemodialysisAhmed Alkhaqani
This study aimed to measure the physical performance of 62 patients undergoing hemodialysis using the Short Physical Performance Battery (SPPB) scale. The study found that the patients' physical performance was below predicted levels at baseline and deteriorated further over three assessments spaced four weeks apart. The results indicated poor physical performance in patients with chronic kidney disease undergoing hemodialysis. This was related to low physical activity levels in this patient population rather than demographic or clinical factors.
This document provides information about the Global Initiative for Asthma (GINA) and its 2014 strategy for asthma management and prevention. It lists the members of GINA's Board of Directors and Science Committee who developed the strategy. The strategy is intended to provide guidance for healthcare providers on diagnosing and managing asthma based on the latest evidence and to help improve asthma care worldwide.
This document provides an overview of the Global Initiative for Asthma (GINA) and its 2014 strategy report for asthma management and prevention. GINA is an international collaboration of healthcare professionals and organizations working to improve asthma care worldwide. The report was developed by GINA's Board of Directors and Science Committee, with input from additional contributors and external reviewers. It provides evidence-based recommendations for diagnosing and treating asthma across all age groups. The goal is to help improve asthma control and reduce the global health burden of this chronic condition through implementation of effective clinical guidelines.
Impact of a designed nursing intervention protocol on myocardial infarction p...Alexander Decker
This study examined the impact of a designed nursing intervention protocol on myocardial infarction patients' outcomes at a university hospital in Egypt. Forty adult myocardial infarction patients were included. The study found that after exposure to the nursing intervention protocol, patients had significantly higher total mean knowledge scores and total mean practice scores. It also found that patients had medium to high levels of compliance to lifelong instructions. The results support the hypotheses that the nursing intervention protocol improved patients' knowledge, practices, and compliance. The study concluded that a nursing intervention protocol can have a positive impact on myocardial infarction patient outcomes.
The document provides an overview of the American Diabetes Association's Standards of Medical Care in Diabetes and related documents. It discusses that the Standards of Care are intended to provide up-to-date clinical practice guidelines for diabetes care and are reviewed annually. It also describes the different types of documents produced by the ADA including Standards of Care, statements, consensus reports, and scientific reviews. Finally, it outlines the grading system used to evaluate the strength of evidence for recommendations in the Standards of Care.
The gap between clinical practice and limited evidence of traditional Chinese...LucyPi1
Traditional Chinese medicine (TCM) is the set of knowledge and practices concerning life, health, illness prevention, and treatment that originated in China thousands of years ago. Presently, TCM is still one of the mainstream medical systems, and has been given an equal legal status and place as Western medicine in the healthcare system of China [1]. Whether it was the plague in ancient times or the SARS and influenza A in the past decades, TCM has always played a major role in the prevention and treatment of diseases [2]. As early as the outbreak of COVID-19 in January 2020, the Chinese government established the treatment principle of integrated Chinese and Western medicine, and since then TCM has been fully and deeply involved in the management of the epidemic in China. Till August 18, 2020, the Chinese health authority had issued eight versions of guidelines for the diagnosis and treatment of COVID-19, and starting from the third version, a TCM approach including herbal formulae and drugs has been included. According to the White Paper issued by the Chinese government in June 2020, 92% of all confirmed cases received TCM-based treatment that proved to be effective [3].
Study of Barthel Score among CKD Patients Belonging from Tribal Areas in Tert...ijtsrd
Chronic Kidney Disease CKD is one of the independent diseases which can lead to sever disability and it is a major emerging public health concern worldwide because it often leads to poor patient outcome 1 . Some of the associated factor with impaired functional status with CKD patients has not been fully elucidated, but some traditional such as cardiovascular diseases hypertension, myocardial ischemia , cerebrovascular diseases, and diabetes mellitus as well as non-traditional factors such as malnutrition-inflammation syndrome and depression may involve. A cross-sectional and longitudinal study has shown that risk of low functional status is directly proportional to kidney impairment 2, 3 . Thus, individuals with chronic kidney disease CKD have 40-70 higher risk of functional limitation than those without CKD 4 . In one study to assess the functional status of the CKD patients by using Barthel index found that 50 patients were dependent for the basic activities of daily life 5 In the current study, we hypothesize that there is a close relationship between the presence of CKD and the functional status of renal patients. We conducted this study with objective to assess the functional status of patients with Chronic Kidney Disease by using Barthel Index as a assessment tool on patients who were admitted under Nephrology Unite of Dr. B.R.A.M Hospital Raipur, CG. Dr. Dolly Ajwani Ratre | Rashmi Nande | Navin Kumar Ratre "Study of Barthel Score among CKD Patients Belonging from Tribal Areas in Tertiary Care Hospital, Chhattisgarh" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-2 , February 2019, URL: https://www.ijtsrd.com/papers/ijtsrd20266.pdf
Paper URL: https://www.ijtsrd.com/medicine/other/20266/study-of-barthel-score-among-ckd-patients-belonging-from-tribal-areas-in-tertiary-care-hospital-chhattisgarh/dr-dolly-ajwani-ratre
Tokyo guidelines for cholangitis and cholecystitis Thorsang Chayovan
The document presents the Tokyo Guidelines for the management of acute cholangitis and cholecystitis. It was created by an international working group to address the lack of standardized diagnostic criteria and treatment guidelines for biliary infections. The working group conducted an extensive literature review, found little high-level evidence, and thus developed the guidelines through international consensus meetings. The Tokyo Guidelines provide evidence-based diagnostic criteria, severity assessments, and management recommendations for acute cholangitis and cholecystitis. They aim to establish international standards for evaluating and treating biliary infections.
Management of Diabetic Ketoacidosis DKA 2013 Guidelines.pdfDr Musadiq
This document provides guidelines for the management of diabetic ketoacidosis (DKA) in adults. It recommends managing DKA based on bedside monitoring of blood glucose and ketone levels using portable meters. The key steps in treatment include administering a fixed rate intravenous insulin infusion to suppress ketones and reverse acidosis, closely monitoring electrolytes, and involving the diabetes specialist team as soon as possible. Measurement of blood ketones rather than just glucose is important for assessing resolution of DKA. The guidelines emphasize point-of-care monitoring and emphasize the role of the diabetes specialist team in management and discharge planning.
C12 british diabetes societies management of dka 2013Diabetes for all
This document provides guidelines for the management of diabetic ketoacidosis (DKA) in adults. It recommends monitoring blood ketone levels using bedside meters as the primary indicator for assessing treatment response, rather than solely relying on blood glucose levels. The guidelines emphasize early involvement of diabetes specialist teams and note that mortality from DKA has declined significantly with improved care practices. The guidelines were updated in 2013 to reflect developments in near-patient testing technology and changes in how DKA often presents.
The Importance of Framing at the Beginning of an Review Dialoguekomalicarol
Long-term care of patients with chronic conditions in general practice rarely focuses on the treatment process. A specific interaction
tool, the Review Dialogue (RD), has been developed to integrate
patients’ health-related problems/risks as well as coping strategies
and to agree upon shared treatment objectives assuming that periodical RDs will help to achieve them. Initiated by the GP, the RD
changes the role expectations of the patient and doctor. Therefore,
the framing of the encounters is of particular importance.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.