POSEIDONE 1 and 2: Probable Causes and Proposed Treatment Strategies? An Evidence-based Update

There is substantial variability in the implementation of evidence-based interventions across the United States, which leads to inconsistent access to evidence-based prevention and treatment strategies at a population level. Increased dissemination and implementation of evidence-based interventions could result in significant public health gains. While the availability of evidence-based interventions is increasing, study of implementation, adaptation, and dissemination has only recently gained attention in public health. To date, insufficient attention has been given to the issue of fidelity. Consideration of fidelity is necessary to balance the need for internal and external validity across the research continuum. There is also a need for a more robust literature to increase knowledge about factors that influence fidelity, strategies for maximizing fidelity, methods for measuring and analyzing fidelity, and examining sources of variability in implementation fidelity.

Download Full-text

Survey of Rejection Prophylaxis Following Suture Removal in Penetrating Keratoplasty in Germany

Klinische Monatsblätter für Augenheilkunde ◽

10.1055/a-1353-6149 ◽

2021 ◽

Author(s):

Sonja Heinzelmann ◽

Daniel Böhringer ◽

Philip Christian Maier ◽

Berthold Seitz ◽

Claus Cursiefen ◽

...

Keyword(s):

Graft Rejection ◽

Graft Failure ◽

Penetrating Keratoplasty ◽

Treatment Strategies ◽

Cost Benefit ◽

Topical Steroids ◽

Evidence Based ◽

Systematic Analysis ◽

Open Questions ◽

The Face

Abstract Background Penetrating keratoplasty (PK) gets more and more reserved to cases of increasing complexity. In such cases, ocular comorbidities may limit graft survival following PK. A major cause for graft failure is endothelial graft rejection. Suture removal is a known risk factor for graft rejection. Nevertheless, there is no evidence-based regimen for rejection prophylaxis following suture removal. Therefore, a survey of rejection prophylaxis was conducted at 7 German keratoplasty centres. Objective The aim of the study was documentation of the variability of medicinal aftercare following suture removal in Germany. Methods Seven German keratoplasty centres with the highest numbers for PK were selected. The centres were sent a survey consisting of half-open questions. The centres performed a mean of 140 PK in 2018. The return rate was 100%. The findings were tabulated. Results All centres perform a double-running cross-stitch suture for standard PK, as well as a treatment for rejection prophylaxis with topical steroids after suture removal. There are differences in intensity (1 – 5 times daily) and tapering (2 – 20 weeks) of the topical steroids following suture removal. Two centres additionally use systemic steroids for a few days. Discussion Rejection prophylaxis following PK is currently poorly standardised and not evidence-based. All included centres perform medical aftercare following suture removal. It is assumed that different treatment strategies show different cost-benefit ratios. In the face of the diversity, a systematic analysis is required to develop an optimised regimen for all patients.

Download Full-text

Biomarkers for sepsis: past, present and future

Italian Journal of Medicine ◽

10.4081/itjm.2016.795 ◽

2016 ◽

Vol 10 (4) ◽

pp. 301 ◽

Cited By ~ 1

Author(s):

Giuseppe Chesi ◽

Natale Vazzana ◽

Claudio Giumelli

Keyword(s):

Clinical Practice ◽

Risk Stratification ◽

Supportive Care ◽

Early Identification ◽

Antibiotic Stewardship ◽

Treatment Strategies ◽

Severe Infection ◽

Antibiotic Use ◽

Evidence Based ◽

Drug Resistant

Sepsis is a complication of severe infection associated with high mortality and open diagnostic issues. Treatment strategies are currently limited and essentially based on prompt recognition, aggressive supportive care and early antibiotic treatment. In the last years, extensive antibiotic use has led to selection, propagation and maintenance of drug-resistant microorganisms. In this context, several biomarkers have been proposed for early identification, etiological definition, risk stratification and improving antibiotic stewardship in septic patient care. Among these molecules, only a few have been translated into clinical practice. In this review, we provided an updated overview of established and developing biomarkers for sepsis, focusing our attention on their pathophysiological profile, advantages, limitations, and appropriate evidence-based use in the management of septic patients.

Download Full-text

Treatment strategies for ADHD: an evidence-based guide to select optimal treatment

Molecular Psychiatry ◽

10.1038/s41380-018-0116-3 ◽

2018 ◽

Vol 24 (3) ◽

pp. 390-408 ◽

Cited By ~ 22

Author(s):

Arthur Caye ◽

James M. Swanson ◽

David Coghill ◽

Luis Augusto Rohde

Keyword(s):

Treatment Strategies ◽

Optimal Treatment ◽

Evidence Based

Download Full-text

Neurobiology and Treatment of OCD

Neurobiology of Mental Illness ◽

10.1093/med/9780199934959.003.0048 ◽

2013 ◽

pp. 646-661

Author(s):

Susanne E. Ahmari ◽

H. Blair Simpson

Keyword(s):

Environmental Factors ◽

Behavioral Therapy ◽

Treatment Strategies ◽

Current Evidence ◽

Evidence Based ◽

Preclinical Studies ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Evidence Based Treatments ◽

Genetic And Environmental Factors

Obsessive Compulsive Disorder (OCD) is a chronic, disabling disorder with a lifetime prevalence of up to 2-3%, and is a leading cause of illness-related disability. OCD is characterized by recurrent intrusive thoughts, images, or impulses (obsessions) that cause anxiety or distress, and repetitive mental or behavioral acts (compulsions). Though the etiology of OCD is unclear, current evidence implicates both genetic and environmental factors in its development. Our understanding of the neurobiology underlying OCD is still evolving, with convergent evidence from clinical and preclinical studies highlighting the importance of abnormalities in cortico-striatal-thalamo-cortical (CSTC) circuits. Evidence-based treatments for OCD include both pharmacotherapy and cognitive-behavioral therapy. This chapter will review the etiology and neurobiology of OCD, and will provide an overview of treatment strategies.

Download Full-text

Fatigue and HIV

10.1093/med/9780199392742.003.0024 ◽

2017 ◽

Author(s):

William Breitbart ◽

Anna L. Dickerman

Keyword(s):

Quality Of Life ◽

Treatment Adherence ◽

Symptom Management ◽

Treatment Strategies ◽

Hiv And Aids ◽

Evidence Based ◽

Important Condition ◽

Evidence Based Treatment ◽

The Past

Fatigue is commonly reported by persons with HIV and AIDS and is associated with impaired physical function, reduced quality of life, and suboptimal treatment adherence. Patients regard fatigue as an important condition to be addressed because it is disabling and distressing. In the past, fatigue was overlooked and undertreated by physicians, but clinicians caring for persons with HIV and AIDS have been giving more attention to symptom management and patients’ quality of life. Increased attention to symptom management in HIV and AIDS warrants familiarity with major issues in evaluation and treatment of fatigue. This chapter reviews the definition and assessment of fatigue, prevalence of fatigue in HIV/AIDS and its impact on patients, medical and psychological causes of fatigue, and evidence-based treatment strategies.

Download Full-text

Mutual relationship between heart failure and atrial fibrillation

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2020.1264 ◽

2020 ◽

Vol 90 (4) ◽

Author(s):

Filippo M. Sarullo ◽

Giuseppe Schembri ◽

Cinzia Nugara ◽

Silvia Sarullo ◽

Giuseppe Vitale ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Health Care Expenditure ◽

Treatment Strategies ◽

Mortality Rates ◽

Healthcare Systems ◽

Adverse Outcomes ◽

Evidence Based ◽

Potential Treatment ◽

The Common

Atrial fibrillation (AF) and heart failure (HF) are evolving epidemies, together responsible for substantial human suffering and health-care expenditure. The simultaneous co-hexistence of the two conditions is associated with mortality rates higher than those observed in individuals with only one or none of them. Patients with concomitant HF and AF suffer from even worse symptoms and poorer prognosis, yet evidence-based evaluation and management of this group of patients is lacking. In this review, we evaluate the common mechanisms for the development of AF in HF patients and vice versa, focusing on the evidence for potential treatment strategies. Recent data have suggested that these patients may respond differently if compared to those with HF or AF alone. These results highlight the clear clinical need to identify and treat these diseases according to best evidence, in order to prevent adverse outcomes and reduce the huge burden that HF and AF are expected to have on global healthcare systems in the future.

Download Full-text