scholarly journals Multiple ligament knee injuries: Clinical practice guidelines

2021 ◽  
Vol 0 ◽  
pp. 1-10
Author(s):  
Dinshaw N. Pardiwala ◽  
Kushalappa Subbiah ◽  
Raghavendraswami Thete ◽  
Ravikant Jadhav ◽  
Nandan Rao
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Treatment Options ◽  
Knee Injuries ◽  
Knee Ligament ◽  
Meniscus Tears ◽  
High Level ◽  
Individualized Management ◽  
Tissue Trauma

Multiple ligament knee injuries involve tears of two or more of the four major knee ligament structures, and are commonly noted following knee dislocations. These devastating injuries are often associated with soft-tissue trauma, neurovascular deficit, and concomitant articular cartilage or meniscus tears. The complexity of presentation, and spectrum of treatment options, makes these injuries unique and extremely challenging to even the most experienced knee surgeons. A high level of suspicion, and a comprehensive clinical and radiological examination, is required to identify all injured structures. The current literature supports surgical management of these injuries, with cruciate reconstructions, and repair/augmented repair/ reconstruction of collateral ligaments. This review article analyses management principle of multiple ligament knee injuries, and formulates clinical practice guidelines with treatment algorithms essential to plan individualized management of these complex heterogeneous injuries.

scholarly journals Primary Thromboprophylaxis in Pancreatic Cancer Patients: Why Clinical Practice Guidelines Should Be Implemented

Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 618 ◽  
Author(s):  
Dominique Farge ◽  
Barbara Bournet ◽  
Thierry Conroy ◽  
Eric Vicaut ◽  
Janusz Rak ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Clinical Practice ◽  
Cancer Patients ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Randomized Trials ◽  
Treatment Options ◽  
Locally Advanced ◽  
Ductal Adenocarcinoma ◽  
Recent Advances

Exocrine pancreatic ductal adenocarcinoma, simply referred to as pancreatic cancer (PC) has the worst prognosis of any malignancy. Despite recent advances in the use of adjuvant chemotherapy in PC, the prognosis remains poor, with fewer than 8% of patients being alive at 5 years after diagnosis. The prevalence of PC has steadily increased over the past decades, and it is projected to become the second-leading cause of cancer-related death by 2030. In this context, optimizing and integrating supportive care is important to improve quality of life and survival. Venous thromboembolism (VTE) is a common but preventable complication in PC patients. VTE occurs in one out of five PC patients and is associated with significantly reduced progression-free survival and overall survival. The appropriate use of primary thromboprophylaxis can drastically and safely reduce the rates of VTE in PC patients as shown from subgroup analysis of non-PC targeted placebo-controlled randomized trials of cancer patients and from two dedicated controlled randomized trials in locally advanced PC patients receiving chemotherapy. Therefore, primary thromboprophylaxis with a Grade 1B evidence level is recommended in locally advanced PC patients receiving chemotherapy by the International Initiative on Cancer and Thrombosis clinical practice guidelines since 2013. However, its use and potential significant clinical benefit continues to be underrecognized worldwide. This narrative review aims to summarize the main recent advances in the field including on the use of individualized risk assessment models to stratify the risk of VTE in each patient with individual available treatment options.

Acute Myeloid Leukemia Clinical Practice Guidelines in Oncology

2003 ◽  
Vol 1 (4) ◽  
pp. 520 ◽  
Keyword(s):  
Clinical Trials ◽  
Acute Myeloid Leukemia ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Myeloid Leukemia ◽  
Treatment Options ◽  
Innovative Strategies ◽  
Recent Version ◽  
Acute Myeloid

The incidence of leukemia, along with its precursor, myelodysplasia, appears to be rising, particularly in the population over age 60. Recently an expanded panel of clinicians from the NCCN member institutions joined to update guidelines for the treatment of acute myeloid leukemia. Although there are some areas in which clinical trials have led to significant improvements in treatment, for the most part, recent trials have only served to highlight the continued need for innovative strategies to overcome this disease. These guidelines focus on outlining reasonable treatment options based on the information available. For the most recent version of the guidelines, please visit NCCN.org

scholarly journals Evaluating the impact of investing in the industry of clinical practice guidelines for health systems

2021 ◽  
Author(s):  
Amal Hassanien
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Clinical Practice ◽  
Literature Review ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Online Survey ◽  
Sustainable Investment ◽  
High Level ◽  
The Impact

Abstract Rationale: This research has been conducted to facilitate evidence-informed policymaking and to help health-care policymakers in Saudi Arabia to decide whether or not a sustainable investment in the CPG industry is socially and economically viable. Objectives: The objective is to investigate: (i) whether the clinical practice guidelines help to improve clinical practice and save costs, and (ii) the views in Saudi Arabia about implementing clinical practice guidelines. Methods: The study employs mixed methods, including: (i) a literature review to evaluate the benefits of implementing clinical practice guidelines, and (ii) an online survey to investigate views about implementing the guidelines' benefits. Results: (i) The clinical practice guidelines do help in improving clinical practice, but the evidence about their impact on saving costs is insufficient in the literature. (ii) The survey demonstrated a high level of awareness among health system actors in Saudi Arabia of the importance of having nationally unified clinical guidelines. Recommendations: Investment in the clinical practice guidelines industry seems socially and economically viable.

scholarly journals A protocol for a systematic review of clinical practice guidelines for the antenatal management of dichorionic diamniotic twin pregnancy

2021 ◽  
Vol 4 ◽  
pp. 115
Author(s):  
Caroline O'Connor ◽  
Sara Leitao ◽  
Keelin O'Donoghue
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
High Income ◽  
Antenatal Management ◽  
High Level ◽  
Twin Pregnancies

Overview: The protocol outlines the process designed to systematically review clinical practice guidelines (CPGs), addressing the antenatal management of dichorionic diamniotic (DCDA) twin pregnancies. Background: CPGs are statements that include recommendations intended to optimise patient care, that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. CPGs are typically created by scientific institutes, organisations and professional societies, and high-quality CPGs are fundamental to improve patient outcomes, standardise clinical practice and improve the quality of care. While CPGs are designed to improve the quality of care, to achieve this, the identification and appraisal of current international CPGs is required. Because twin pregnancies are identified as high-risk pregnancies, a systematic review of the CPGs in this field is a useful first step for establishing the required high level of care. Aim: The aim of the systematic review is to identify, appraise and examine published CPGs for the antenatal management of DCDA twin pregnancies, within high-income countries.  Methods: We will identify published CPGs addressing any aspect of antenatal management of care in DCDA twin pregnancies, appraise the quality of the identified CPGs using the Appraisal of Guidelines for Research and Evaluation version 2 (AGREE II) the Appraisal of Guidelines Research and Evaluation – Recommendations excellence (AGREE-REX) instruments and examining the recommendations from the identified CPGs. Ultimately, this protocol aspires to clearly define the process for a reproducible systematic review of CPGs within a high-income country, addressing any aspect of antenatal management of DCDA twin pregnancies. PROSPERO registration: CRD42021248586 (24/06/2021)

scholarly journals Acute Myeloid Leukemia, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

2019 ◽  
Vol 17 (6) ◽  
pp. 721-749 ◽  
Author(s):  
Martin S. Tallman ◽  
Eunice S. Wang ◽  
Jessica K. Altman ◽  
Frederick R. Appelbaum ◽  
Vijaya Raj Bhatt ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Myeloid Leukemia ◽  
Treatment Options ◽  
The United States ◽  
Nccn Guidelines ◽  
Younger Age ◽  
Acute Myeloid

Acute myeloid leukemia (AML) is the most common form of acute leukemia among adults and accounts for the largest number of annual deaths due to leukemias in the United States. Recent advances have resulted in an expansion of treatment options for AML, especially concerning targeted therapies and low-intensity regimens. This portion of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for AML focuses on the management of AML and provides recommendations on the workup, diagnostic evaluation and treatment options for younger (age <60 years) and older (age ≥60 years) adult patients.

scholarly journals Clinical Practice Guidelines for the Treatment of Functional Dyspepsia in Korea

2021 ◽  
Vol 96 (2) ◽  
pp. 116-138
Author(s):  
Jung Hwan Oh ◽  
Joong Goo Kwon ◽  
Hye-Kyung Jung ◽  
Chung Hyun Tae ◽  
Kyung Ho Song ◽  
...  
Keyword(s):  
Systematic Review ◽  
Helicobacter Pylori ◽  
Clinical Practice ◽  
Functional Dyspepsia ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Meta Analysis ◽  
Treatment Options ◽  
Korean Society ◽  
Guidelines Development

Background/Aims: Functional dyspepsia (FD) is a chronic upper gastrointestinal symptom complex that routine diagnostic work-up, such as endoscopy, blood laboratory analysis, or radiological examination, fails to identify a cause for. It is highly prevalent in the Korean population, and its response to the various available therapeutic strategies is only modest because of the heterogeneous nature of its pathogenesis. We constituted a guidelines development committee to review the existing guidelines on the management of FD.Methods: This committee drafted statements and conducted a systematic review and meta-analysis of various studies, guidelines, and randomized control trials. External review was also conducted by selected experts. These clinical practice guidelines for FD were developed based on evidence recently accumulated with the revised version of FD guidelines released in 2011 by the Korean Society of Neurogastroenterology and Motility.Results: These guidelines apply to adults with chronic symptoms of FD and include the diagnostic role of endoscopy, <i>Helicobacter pylori</i> screening, and systematic review and meta-analyses of the various treatment options for FD (proton pump inhibitors, <i>Helicobacter pylori</i> eradication, and tricyclic antidepressants), especially according to the FD subtype.Conclusions: The purpose of these new guidelines is to aid understanding, diagnosis, and treatment of FD, and the targets of the guidelines are clinicians, healthcare workers at the forefront of patient care, patients, and medical students. The guidelines will continue to be revised and updated periodically.

High Flow Oxygen Therapy and the Pressure to Feed Infants With Acute Respiratory Illness

2020 ◽  
Vol 5 (4) ◽  
pp. 1006-1010
Author(s):  
Jennifer Raminick ◽  
Hema Desai
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Oxygen Therapy ◽  
Respiratory Illness ◽  
High Flow ◽  
Oral Feeding ◽  
Respiratory Support ◽  
Acute Respiratory Illness ◽  
High Flow Oxygen

Purpose Infants hospitalized for an acute respiratory illness often require the use of noninvasive respiratory support during the initial stage to improve their breathing. High flow oxygen therapy (HFOT) is becoming a more popular means of noninvasive respiratory support, often used to treat respiratory syncytial virus/bronchiolitis. These infants present with tachypnea and coughing, resulting in difficulties in coordinating sucking and swallowing. However, they are often allowed to feed orally despite having high respiratory rate, increased work of breathing and on HFOT, placing them at risk for aspiration. Feeding therapists who work with these infants have raised concerns that HFOT creates an additional risk factor for swallowing dysfunction, especially with infants who have compromised airways or other comorbidities. There is emerging literature concluding changes in pharyngeal pressures with HFOT, as well as aspiration in preterm neonates who are on nasal continuous positive airway pressure. However, there is no existing research exploring the effect of HFOT on swallowing in infants with acute respiratory illness. This discussion will present findings from literature on HFOT, oral feeding in the acutely ill infant population, and present clinical practice guidelines for safe feeding during critical care admission for acute respiratory illness. Conclusion Guidelines for safety of oral feeds for infants with acute respiratory illness on HFOT do not exist. However, providers and parents continue to want to provide oral feeds despite clinical signs of respiratory distress and coughing. To address this challenge, we initiated a process change to use clinical bedside evaluation and a “cross-systems approach” to provide recommendations for safer oral feeds while on HFOT as the infant is recovering from illness. Use of standardized feeding evaluation and protocol have improved consistency of practice within our department. However, further research is still necessary to develop clinical practice guidelines for safe oral feeding for infants on HFOT.

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