What Constitutes Evidence-Based Pharmacotherapy for Bipolar Disorder? Part 1: First-Line Treatments

2007 ◽  
Vol 68 (12) ◽  
pp. 1982-1983 ◽  
Author(s):  
Joseph F. Goldberg
Keyword(s):  
Bipolar Disorder ◽  
Evidence Based ◽  
First Line

The treatment of bipolar disorder in the elderly

2017 ◽  
Author(s):  
Gilberto Sousa Alves ◽  
Felipe Kenji Sudo ◽  
Johannes Pantel
Keyword(s):  
Bipolar Disorder ◽  
Gold Standard ◽  
Atypical Antipsychotics ◽  
Extended Release ◽  
Ethical Issues ◽  
The Elderly ◽  
Evidence Based ◽  
Pharmacological Interventions ◽  
First Line ◽  
Evidence Based Guidelines

Bipolar disorder (BD) is an extremely disabling condition characterized by mood switches, and cognitive and functional impairment. The current chapter discusses the updated review on pharmacological and non-pharmacological interventions targeting BD in the elderly. The risk of concurrent medical diseases (eg, metabolic syndrome) and relatively lower tolerability than young BD make the patient safety a major concern in most cases. Evidence-based guidelines, although useful for promoting rational and effective therapy, are generally lacking in elderly BD. Current recommendations for acute mania include atypical antipsychotics, careful use of lithium, and election of valproate as the gold-standard therapy. In acute BD depression, first-line agents in monotherapy may include lithium, lamotrigine, quetiapine, and quetiapine extended release (XR). Electroconvulsive therapy may be an option for severe/refractory cases. Family members or caregivers should be encouraged to support the patient, since potential ethical issues involving patrimony or profession may arise during the treatment.

scholarly journals Evidence-based strategies improve assessment of pediatric bipolar disorder by community practitioners.

2011 ◽  
Vol 42 (2) ◽  
pp. 121-129 ◽  
Author(s):  
Melissa M. Jenkins ◽  
Eric A. Youngstrom ◽  
Jason J. Washburn ◽  
Jennifer Kogos Youngstrom
Keyword(s):  
Bipolar Disorder ◽  
Pediatric Bipolar Disorder ◽  
Evidence Based

Experience with an evidence-based protocol using fibrinolysis as first line treatment for empyema in children

2013 ◽  
Vol 48 (6) ◽  
pp. 1312-1315 ◽  
Author(s):  
Alessandra C. Gasior ◽  
E. Marty Knott ◽  
Susan W. Sharp ◽  
Daniel J. Ostlie ◽  
George W. Holcomb ◽  
...  
Keyword(s):  
Evidence Based ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

scholarly journals Canada's Progress to Make Smoking Cessation a First-Line Cancer Treatment

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 90s-90s
Author(s):  
M. Halligan ◽  
D. Keen
Keyword(s):  
Smoking Cessation ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Smoking Status ◽  
Scale Up ◽  
Evidence Based ◽  
First Line ◽  
Quit Smoking ◽  
Substantial Progress ◽  
Oncology Practice

Background: Evidence indicates that smoking cessation improves the effectiveness of treatment and likelihood of survival among all cancer patients, not just those with tobacco-related disease, yet smoking is rarely addressed in oncology practice. Prior to 2016, only 3 provinces in Canada (out of a total of 10 provinces and three territories) reported implementation of smoking cessation for ambulatory cancer patients. Aim: Based on this evidence, the Canadian Partnership Against Cancer (CPAC) implemented a systems change initiative to promote adoption of evidence-based smoking cessation within provincial and territorial cancer systems across Canada. Methods: In 2016, CPAC funded seven provinces and two territories over a 15-month period to plan, implement or evaluate integration of evidence-based smoking cessation for ambulatory cancer patients within cancer systems. Funds were used to plan (2 provinces and 2 territories), implement (3 provinces) or evaluate (2 provinces) systematic, evidence-based approaches to smoking cessation within ambulatory cancer care settings (e.g., establishing routine systems for identification of smoking cancer patients and system to support patients to quit). Funds could not be used for direct service delivery (e.g., cessation counseling). Results: After 15-months of funding from CPAC, 6 provinces reported implementation of smoking cessation for ambulatory cancer patients. The remaining province and 2 territories funded by CPAC reported development of plans for adoption of smoking cessation for cancer patients in the future. Within provinces reporting implementation of smoking cessation for cancer patients, between 65%-97% of ambulatory cancer patients were screened for smoking status; 22%-80% of these patients were offered a referral to cessation services, and 21%-45% of cancer patients accepted a referral. Conclusion: Despite provincial and territorial variations in readiness to uptake evidence-based smoking cessation for cancer patients, CPAC's approach has led to substantial progress in adoption of this approach across Canada. While progress has been made, adoption of smoking cessation and relapse prevention by cancer systems is not yet widespread in Canada. Scale-up to remaining provinces and territory, and spread within existing provinces and territories is required to reach all cancer patients and families who require support to quit smoking. Framing smoking cessation as a therapeutic intervention, not prevention, and a routine part of cancer treatment will be critical for sustainability of this work.

scholarly journals The Role of Catheter Directed Thrombolysis on Acute Limb Ischemia (an Evidence-Based Case Report)

2021 ◽  
Vol 49 (1) ◽  
pp. 3-24
Author(s):  
Ali Farhan Fathoni ◽  
Raden Suhartono
Keyword(s):  
Case Report ◽  
Adult Patient ◽  
Controlled Trial ◽  
Limb Ischemia ◽  
Evidence Based ◽  
Acute Limb Ischemia ◽  
First Line ◽  
Bleeding Events ◽  
Catheter Directed Thrombolysis ◽  
Significant Difference

Introduction. Acute limb ischemia can be managed both with surgery and thrombolysis, especially catheter-directed thrombolysis. The risk, benefit and indication of thrombolysis is already well known. However, as a first line therapy, it is unclear which intervention is more beneficial; the catheter directed thrombolysis or surgery. This report aims to elucidate which technique is more effective and safer. Method. This is an Evidence-Based Case Report based on a case of a geriatric, diabetic patient whom suffered acute limb ischemia. The report systematically search for meta-analysis, systematic review, randomized controlled trial and cohort studies from Cochrane central and PubMed for all adult patient suffering from acute limb ischemia whose are treated with catheter-directed thrombolysis or surgery as first-line intervention and comparing the outcome in terms of efficacy (clinical outcome such as patency and amputation-free rates) and safety (mortality and morbidity). Results. Subjects’ characteristics should be placed first to draw the demography. Put the study finding(s) here with no interpretation. For all adult patient regardless of their diabetic status and age there is no statistically significant difference for limb salvage, amputation, and mortality between two technique, however catheter directed thrombolysis showed reduced need for additional intervention whilst increasing risk of bleeding events. Conclusion. Neither techniques are more superior than the other but catheter-directed thrombolysis can be considered given that it reduce the need for further intervention, less invasive and even though it has risks for bleeding complication it is still lower compared to systemic thrombolysis. The selection of which technique can be up to clinician’s discretion in consideration of risk and benefit for each patient.

scholarly journals Prescribing Optimal Nutrition and Physical Activity as “First-Line” Interventions for Best Practice Management of Chronic Low-Grade Inflammation Associated with Osteoarthritis: Evidence Synthesis

Arthritis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-28 ◽  
Author(s):  
Elizabeth Dean ◽  
Rasmus Gormsen Hansen
Keyword(s):  
Oxidative Stress ◽  
Behavior Change ◽  
Best Practice ◽  
Evidence Synthesis ◽  
Low Grade ◽  
Evidence Based ◽  
First Line ◽  
Lifestyle Behavior ◽  
Low Grade Inflammation ◽  
And Oxidative Stress

Low-grade inflammation and oxidative stress underlie chronic osteoarthritis. Although best-practice guidelines for osteoarthritis emphasize self-management including weight control and exercise, the role of lifestyle behavior change to address chronic low-grade inflammation has not been a focus of first-line management. This paper synthesizes the literature that supports the idea in which the Western diet and inactivity are proinflammatory, whereas a plant-based diet and activity are anti-inflammatory, and that low-grade inflammation and oxidative stress underlying osteoarthritis often coexist with lifestyle-related risk factors and conditions. We provide evidence-informed recommendations on how lifestyle behavior change can be integrated into “first-line” osteoarthritis management through teamwork and targeted evidence-based interventions. Healthy living can be exploited to reduce inflammation, oxidative stress, and related pain and disability and improve patients’ overall health. This approach aligns with evidence-based best practice and holds the promise of eliminating or reducing chronic low-grade inflammation, attenuating disease progression, reducing weight, maximizing health by minimizing a patient’s risk or manifestations of other lifestyle-related conditions hallmarked by chronic low-grade inflammation, and reducing the need for medications and surgery. This approach provides an informed cost effective basis for prevention, potential reversal, and management of signs and symptoms of chronic osteoarthritis and has implications for research paradigms in osteoarthritis.

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