Guidelines for the Management of Varicose Veins

2012 ◽  
Vol 27 (1_suppl) ◽  
pp. 2-9 ◽  
Author(s):  
P Gloviczki ◽  
M L Gloviczki
Keyword(s):  
Venous Insufficiency ◽  
Varicose Veins ◽  
Imaging Techniques ◽  
Scientific Evidence ◽  
Clinical Excellence ◽  
Evidence Based ◽  
Published Evidence ◽  
Ablation Laser ◽  
The World ◽  
Evidence Based Guidelines

Recently published evidence-based guidelines of the Society for Vascular Surgery (SVS) and the American Venous Forum (AVF) include recommendations for evaluation, classification, outcome assessment and therapy of patients with varicose veins and more advanced chronic venous insufficiency (CVI). The need for such guidelines has been evident since imaging techniques and minimally invasive technologies have progressed by leaps and bounds and radiofrequency ablation, laser and sclerotherapy have largely replaced classical open surgery of saphenous stripping. This report reviews the most important guidelines recommended by the SVS/AVF Venous Guideline Committee. It is obvious, however, that some of the technology that is recommended in North America is either not available or not affordable in some parts of the world for patients with varicose veins and CVI. The readers are urged therefore to also consult the guidelines of their national societies, recent publications of the National Institute for Clinical Excellence and the Venous Forum of the Royal Society of Medicine. Venous specialists should also keep in mind that scientific evidence should always be combined with the physician's clinical experience and the patient's preference when the best treatment is selected for an individual patient.

scholarly journals The internet racing ahead of the scientific evidence: the case of "liberation treatment" for multiple sclerosis

2011 ◽  
Vol 69 (3) ◽  
pp. 525-527 ◽  
Author(s):  
Yára Dadalti Fragoso
Keyword(s):  
Multiple Sclerosis ◽  
Neurological Disease ◽  
Venous Insufficiency ◽  
Scientific Evidence ◽  
The Internet ◽  
Evidence Based ◽  
The World ◽  
Internet Discussion ◽  
The Central Nervous System ◽  
The Subject

Multiple sclerosis (MS) is a chronic neurological disease that typically affects young adults. A recent publication suggested that MS might originate from insufficient blood drainage in certain areas of the central nervous system. The condition was named chronic cerebrospinal venous insufficiency (CCSVI). Other papers have not confirmed these findings and, therefore, the matter remains controversial. Nineteen months after the original publication on CCSVI and MS, another 22 papers have been published addressing the matter. No clinical trials have been carried out on the subject and there is no evidence-based indication to perform surgical vascular procedures in MS patients. However, over the same nineteen-month period, the internet discussion on the subject of CCSVI and MS has led to countless websites advertising treatment using vascular surgery for patients with MS all over the world. The treatment based on the CCSVI theory has appealingly been called "liberation treatment", thus making it difficult to explain to patients why a treatment that has been highly praised (on the internet) cannot be recommended based on partial medical results that await confirmation.

scholarly journals Evidence-based practices of effective fire safety education programming for children

2021 ◽  
Vol 10.47389/36 (No 2) ◽  
pp. 34-41
Author(s):  
Kamarah Pooley ◽  
Sonia Nunez ◽  
Mark Whybro
Keyword(s):  
Fire Safety ◽  
Evidence Based ◽  
Safety Education ◽  
Education Programs ◽  
Evidence Based Practices ◽  
Fire Services ◽  
School Based ◽  
The World ◽  
Evidence Based Guidelines ◽  
Safety Knowledge

School-based fire safety education programs are implemented by fire services organisations around the world to improve children’s fire safety knowledge and skills. Such education is considered the single most modifiable strategy that fire services organisations can implement to reduce the risk that children will misuse fire or be harmed by fire. Despite this, there are no overarching and evidence-based guidelines for the development of new programs or the evaluation and modification of existing ones. To fill this void, a rapid evidence assessment of existing literature was conducted. Results revealed 25 evidence-based practices that held true in a variety of contexts and methodologically diverse studies. These practices inform an empirical framework that can be used to guide fire safety education programs for children.

scholarly journals Enthusiasm-Based or Evidence-Based Charities: Personal Reflections Based on the Project P.A.T.H.S. in Hong Kong

2008 ◽  
Vol 8 ◽  
pp. 802-810 ◽  
Author(s):  
Daniel T. L. Shek
Keyword(s):  
Hong Kong ◽  
Scientific Evidence ◽  
Social Needs ◽  
Intervention Programs ◽  
Evidence Based ◽  
Charitable Foundations ◽  
The World ◽  
Research Findings ◽  
Personal Reflections ◽  
The Needy

In charitable foundations throughout the world, different approaches are used to allocate funding. As many projects with good will (i.e., enthusiasm-based charity) actually fail to help those who really need it, it is argued that the evidence-based approach (i.e., charity guided by scientific evidence) represents the best strategy to support projects that can really help the needy. Using this approach, scientific research findings are systematically used to (1) understand the nature of the problem and/or social needs, (2) design appropriate intervention programs based on the best available evidence, and (3) systematically evaluate the outcomes of the developed program. Using the Project P.A.T.H.S. funded by the Hong Kong Jockey Club Charities Trust as an example, the characteristics underlying this approach are outlined. The systematic use of scientific evidence in the Project P.A.T.H.S. is exemplary in different Chinese societies. This project provides much insight for charitable foundations and funding bodies locally and globally.

Press Report: Who Criticized for Neglecting Evidence

2007 ◽  
Vol 37 (4) ◽  
pp. 783-785
Author(s):  
Maria Cheng ◽  
Jean McMahon
Keyword(s):  
World Health Organization ◽  
World Health ◽  
Evidence Based ◽  
The World ◽  
Press Report ◽  
Health Organization ◽  
Evidence Based Guidelines

A study published in The Lancet reveals that when developing “evidence-based” guidelines, the World Health Organization routinely forgets one key ingredient: evidence. The study is based on interviews with senior WHO officials and analyses of various guidelines to determine how they were produced. The authors found a distinctly non-transparent process.

scholarly journals Health professionals’ adherence to evidence-based obesity guidelines: a cohort study.

2019 ◽  
Author(s):  
Nuria Trujillo Garrido ◽  
Mariangeles Bernal ◽  
Maria José Santi Cano
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Professionals ◽  
Medical Records ◽  
Scientific Evidence ◽  
Behavioural Change ◽  
Overweight And Obesity ◽  
Evidence Based ◽  
Practice Methods ◽  
Evidence Based Guidelines

Abstract BACKGROUND The prevalence of obesity is on the increase worldwide and yet scientific evidence shows that primary care professionals are not adequately addressing overweight and obesity. In this study, we evaluate how obesity guidelines are being implemented in routine clinical practice. METHODS The study obtained the following data on a cohort of 209 obese patients attending primary care consultations: electronic medical records, body mass index (BMI), waist circumference (WC), cardiovascular risk factors, comorbidities and whether or not their health professional adhered to obesity evidence-based guidelines. RESULTS 57.9% of the participants were women and their average age was 65.8 ± 12.7 years. Only 25.4% of the medical records met all the criteria established in the therapeutic guidelines regarding diet prescription. This percentage was significantly higher in males than females (36.4% vs 17.4, p = 0.002). 1.4% met the criteria for physical activity and 1.5% for behavioural change activities. In the multivariate analysis, the variable associated with the most favourable BMI and WC figures, after adjusting for age, was a follow up by health professionals on physical activity (β=0.347, p=0.027, CI=0.429-6.868; β=0.367, p=0.024, CI=1.256-17.556) during routine check-ups with women. CONCLUSIONS We detected low adherence to the evidence-based guidelines among professionals. Recording dietetic prescription and physical exercise in the patient's medical record is associated with a better control of obesity. This data suggest that primary health care should be improved for obese patient.

A Multicenter Drug Use Surveillance of Intravenous Immunoglobulin Utilization in US Academic Health Centers

2000 ◽  
Vol 34 (3) ◽  
pp. 295-299 ◽  
Author(s):  
Connie Chen ◽  
Lynne H Danekas ◽  
Thomas A Ratko ◽  
Peter H Vlasses ◽  
Karl A Matuszewski
Keyword(s):  
Intravenous Immunoglobulin ◽  
Alternative Therapy ◽  
Health Centers ◽  
Academic Health Centers ◽  
Evidence Based ◽  
Product Label ◽  
Academic Health ◽  
Off Label ◽  
Published Evidence ◽  
Evidence Based Guidelines

BACKGROUND: The role of intravenous immunoglobulin (IVIG) in treating a variety of diseases is controversial and under active investigation for at least two reasons: first, a severe shortage of IVIG products exists in the US; second, numerous off-label (not specified in the Food and Drug Administration [FDA]–approved label) uses for IVIG have been, and continue to be, described in the literature. However, most off-label uses are not supported by evidence from properly designed clinical trials. OBJECTIVE: To assess inpatient use of IVIG in a sample of US academic health centers and to compare it with published evidence-based model guidelines for IVIG use. METHODS: Data on the use of IVIG and subsequent clinical outcomes in 251 patients were collected prospectively from 12 institutions. Recommendations from consensus guidelines were used to categorize patients who received IVIG into one of four groups: labeled uses; off-label, recommended; off-label, recommended as alternative; and off-label, not recommended. Outcomes were scored according to guideline criteria. RESULTS: One hundred seven patients (43%) received IVIG for indications contained in the FDA-approved product label, 130 patients (52%) received IVIG for off-label indications, and 14 (5%) received undefined treatment. Among all patients administered IVIG, 31 (12%) were treated for off-label recommended reasons; 64 (26%) received off-label recommended as alternative therapy; and 35 (14%) received off-label not recommended therapy, as defined by model guidelines. Outcomes were not significantly different between the groups. CONCLUSIONS: Our findings suggest that IVIG continues to be used to treat a wide variety of conditions not specified in the product label. Furthermore, a substantial proportion of the reported off-label uses are not recommended according to evidence-based guidelines.

scholarly journals Physiotherapy and Mental Health

2019 ◽  
Vol 18 (2) ◽  
pp. 208-214
Author(s):  
Michel Probst
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Healthy Lifestyle ◽  
Scientific Evidence ◽  
Evidence Based ◽  
Appropriate Care ◽  
Wide Range ◽  
The World ◽  
Movement Awareness ◽  
World Confederation

Physiotherapy in mental health care and psychiatry is recognized by the World Confederation for Physical Therapy (WCPT) as a specialty within physiotherapy. Physiotherapy in mental health offers a wide range of interventions in regard of body functions, physical activity, exercises, sensory, body and movement awareness, stress and tense regulation and pain management, based on clinical and scientific evidence-based literature. Additionally, the promotion of a healthy lifestyle and “physio-education” (i.e. the process of providing education and information regarding specific physiotherapy related topics to patients and their family members) should be a responsibility of the physiotherapist. This paper gives a short overview of the interventions in the field of mental health to offer appropriate care to a specific vulnerable but growing group in our society.

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