Glucocorticoids, commonly used to treat multiple inflammatory processes, can cause hyperglycemia, Cushing syndrome, adrenal suppression, and, when they are discontinued, adrenal insufficiency. Physicians must be aware of these adverse effects and be equipped to manage them.

The Institute of Medicine asserts that evidence-based practice can become a reality because the tools to find the best evidence are available. However, teaching the naïve sophomore how to use these tools while ensuring that this first search experience is successful from both the student and the instructor standpoint is ...

: The American Board of Plastic Surgery Maintenance of Certification program includes the submission of 10 consecutive cases in one of 20 tracer modules for Performance in Practice evaluation. This has resulted in a wealth of data on the practice patterns of Board diplomates. The specific aim of this project ...

Co-management is now established as a mainstream approach to small-scale fisheries management across the developing world. A comprehensive review of 204 potential cases reveals a lack of impact assessments of fisheries co-management. This study reports on a meta-analysis of the impact of fisheries co-management in developing countries in 90 sites ...

PURPOSE OF REVIEW: Malignant pleural effusions (MPEs) are one of the most common problems faced by clinicians and, since there is no optimum treatment available, they deserve efforts aimed to improve their management. RECENT FINDINGS: We have reviewed the most recent articles regarding treatment of MPE, with special emphasis on ...

Barrett's esophageal (BE) metaplasia is a premalignant condition of the distal esophagus that develops as a consequence of gastroesophageal reflux disease. The progression to carcinogenesis results from progressive dysplastic changes of the metaplastic epithelium through low-grade and then high-grade dysplasia (HGD) to eventually adenocarcinoma of the esophagus. The management of ...

OBJECTIVE: To develop methods for systematically reviewing evidence for identifying effective laboratory medicine (LM) practices associated with improved healthcare quality outcomes. RELEVANCE: Although many evidence-evaluation systems have been developed, none are designed to include and rate healthcare quality improvement studies to identify evidence-based practices that improve patient safety and LM ...

Paroxysmal nocturnal haemoglobinuria (PNH) is a serious form of acquired haemolytic anaemia with several features that make it unique, including the fact that it is caused by clonal expansion, in the context of bone marrow failure, of a haematopoietic stem cell that has a somatic mutation in a gene crucial ...

PURPOSE: To appraise primary open-angle glaucoma (POAG) practice guidelines critically and to compare these guidelines' major recommendations. DESIGN: Evaluation of clinical practice guidelines and their development process. PARTICIPANTS: Glaucoma fellowship-trained ophthalmologists. METHODS: The POAG clinical practice guidelines published by the American Academy of Ophthalmology (AAO), European Glaucoma Society (EGS), and ...

PURPOSE OF REVIEW: Placenta accreta is one of the leading causes of peripartum hemorrhage. The goal of this article is to review anesthetic management of parturients with placenta accreta and to examine a modern approach to massive peripartum hemorrhage. RECENT FINDINGS: The incidence of placenta accreta is rising in parallel ...

The decade since the publication of the Human Genome Project draft has ended with the discovery of hundreds of genomic markers related to diseases and phenotypes. However, the project has not yet delivered on its promise to tailor treatments for individuals. The number of genomic markers in clinical practice is ...

Computer and information technology popularizes in the medicine manufacturing enterprise for its potentials in working efficiency and service quality. In allusion to the explosive data and information of application system in current medicine manufacturing enterprise, we desire to propose a novel application information system integration platform in medicine manufacturing enterprise, ...

Emanuel Swedenborg is widely accredited for his religious fervor and devout dedication to his spirituality. He spearheaded the creation of what is known today as the New Jerusalem Church. However, Swedenborg also served as a prominent figure in the European Enlightenment, making noteworthy strides in the fields of mathematics and ...

The National Comprehensive Cancer Network (NCCN) has published guidelines for hereditary breast and ovarian cancer syndrome (HBOCS) management. Little data exist on compliance with these guidelines among different physician specialties. We performed an on-line case-based survey by randomly sampling physicians from five specialties, Family Medicine (FM), Obstetrics and Gynecology (OG), ...

Peripheral intravenous catheter (PIV) insertion is a traumatic experience for children and should not be repeated more frequently than necessary. Proper securement of pediatric IVs can preserve catheter life; however, little evidence is available to describe optimal methods. Pediatric nurses at a 246-bed, community-owned district hospital observed they were frequently ...

To introduce the basic equipment necessary to perform interventional radiology (IR) techniques in the veterinary setting, particularly those procedures of interest to the criticalist. Veterinary and human literature as well as author's experience. Since the 1950s, diagnostic angiography has played an important role in human medicine. However, over the last ...

The Ministry of Health (MOH) publishes clinical practice guidelines on Chronic Hepatitis B Infection to provide doctors and patients in Singapore with evidence-based guidance on managing important medical conditions. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on Chronic ...

Results of Medicare's ACE demonstration project and Geisinger Health System's ProvenCare initiative provide insight into the challenges hospitals will face as bundled payment proliferates. An early analysis of these results suggests that hospitals would benefit from bringing full automation using clinical IT tools to bear in their efforts to meet ...

Most clinical laboratories in the nation report severe difficulties in recruitment and retention of most types of personnel. Other important factors impacting this problem include work complexities, increased automation, and a graying workforce. As a further challenge, institutional needs for clinical laboratory personnel are expected to grow significantly in the ...

Cite this as: S. C. Jones, D. Iverson, P. Burns, U. Evers, P. Caputi and S. Morgan, Clinical & Experimental Allergy, 2011 (41) 471-481. SUMMARY: Despite the high prevalence of asthma in the elderly, its development, diagnosis, and treatment are under-researched. This paper provides a comprehensive review of the current ...

Background: As increasing demands on health care services are posing new challenges to practicing physicians worldwide, physicians have to extend existing and develop new competencies in various domains of their profession. Management and leadership is one of these domains, and relevant competencies have been incorporated in many new competency-based (postgraduate) ...

ABSTRACT: BACKGROUND: Randomised controlled clinical (drug) trials supply high quality evidence for therapeutic strategies in primary care. Until now, experience with drug trials in German general practice has been sparse. In 2007/2008, the authors conducted an investigator-initiated, non-commercial, double-blind, randomised controlled pilot trial (HWI-01) to assess the clinical equivalence of ...

Purpose: Cystic fibrosis (CF) carrier screening guidelines have been in place for almost a decade. The purpose of this study was to determine the current awareness by obstetricians of the existence and content of practice guidelines, the variety in practice regarding CF carrier screening, and the level of knowledge regarding ...

Introduction Individual effort and practice systems contribute to quality performance, but the nature of their contributions remains unclear. Methods This study assessed the roles of individual attributes and behaviours versus practice attributes in quality performance by assessing general internists' perceptions of factors that drive their engagement in quality improvement (QI). ...

Use of viscoelastic point-of-care (POC) coagulation instrumentation is relatively new to veterinary medicine. In human medicine, this technology has recently undergone resurgence owing to its capacity to detect hypercoagulability. The lack of sensitive tests for detecting hypercoagulable states, along with our current understanding of in vivo coagulation, highlights the deficiencies ...

Background: Complementary and alternative medicines often are advocated for infantile colic, yet there has been no synthesis of the evidence to inform current practice about their use. Objective: To critically evaluate all randomized clinical trials of nutritional supplements and other complementary and alternative medicines as a treatment for infantile colic. ...

Diseases causing high mortality in children under 5 years of age in resource limited settings (RLS) could be treated if children in these countries had access to existing medicines. It took 30 years before the WHO Essential Medicines List (EML) considered the issue of medicines for children, with the first ...

Proper critical care training and management rests on 3 pillars-evidence-based patient care, proficient procedural skills, and compassionate end-of-life (EOL) management. The purpose of this manuscript is to provide a practical guide to EOL management for all bedside practitioners. The manuscript outlines not all but some fundamentally important ethical concepts and ...

While the complaints process is intended to improve healthcare, some doctors appear to practise defensive medicine after receiving a complaint. This response occurs in countries that use a tort-based medicolegal system as well as in countries with less professional liability. Defensive medicine is based on avoiding malpractice liability rather than ...

Pruritus is a ubiquitous symptom with a wide range of presentations, often causing considerable distress for many individuals and resulting in reduced quality of life. In recent years there has been renewed interest and increased research activity in this previously neglected field. Although there is still much to be learnt ...

To revise the 2003 version of the American Urological Association's (AUA) Guideline on the management of benign prostatic hyperplasia (BPH). From MEDLINE® searches of English language publications (January 1999 through February 2008) using relevant MeSH terms, articles concerning the management of the index patient, a male ≥45 years of age ...

The techniques used in protein production and structural biology have been developing rapidly, but techniques for recording the laboratory information produced have not kept pace. One approach is the development of laboratory information-management systems (LIMS), which typically use a relational database schema to model and store results from a laboratory ...

Acupuncture is increasingly popular for the treatment of many medical complaints, including gynaecologic conditions. The aim of this study was to summarise the evidence from systematic reviews (SRs) and meta-analyses assessing the efficacy of acupuncture in treating common gynaecologic conditions. Six electronic databases, including two major English-language databases (PubMed and ...

A child with chest pain or tics, a toddler who is limping, a 12-year-old girl with abdominal pain or headaches, an infant whose fever does not respond to antibiotics - these are age-old challenges that pediatricians face. I have been teaching pediatrics to residents and medical students for more than ...

Sharing data with other facilities provides valuable insights. Quality managers can help keep initiatives on track. Constantly monitor compliance, and intervene when necessary.

Benign Paroxysmal Positional Vertigo (BPPV) is characterized by vertigo, lasting for a few seconds and usually managed by head positioning maneuvers. To educate clinicians concerning the state-of-the art knowledge about its management, the international societies developed guidelines. the aim of this paper is to discuss, in a practical fashion, the ...

This Best Practice Information Sheet aims to synthesize the best-available evidence on music as a therapeutic intervention for the management of anxiety or pain related to procedural or operative interventions. The information that is contained in this sheet has been derived from studies that were included in a systematic review ...

Moringa oleifera is an ancient tree that is historically known to possess numerous medicinal qualities. The purpose of this article is to familiarize nurses with the use of Moringa oleifera in traditional medicine, present the findings of evidence-based studies, and provide implications for clinical practice and further research.

<span style="font-weight: bold"> <⁄span> An estimated 350 million people worldwide have chronic hepatitis B (CHB), which is a major cause of cirrhosis and hepatocellular carcinoma. <span style="font-weight: bold"> <⁄span> To assess the level of knowledge among family medicine trainees regarding the identification and management of CHB. <span style="font-weight: bold"> <⁄span>A ...

Background. The performance of safe and effective procedural sedation in the emergency centre has become a core competency in emergency medicine internationally. However, in South Africa clear guidelines are lacking and this guideline attempts to set out the standard for the routine safe use of procedural sedation by clinical staff ...

With the current trend of globalization, unprecedented opportunities and enormous changes have emerged for the global development of traditional Chinese medicine (TCM). However, many old and new challenges and problems still remain, including partial or limited comprehension of acupuncture, oriental medicine and TCM, the existence of non-standardized institutes of TCM ...

Human error in medicine is a significant cause of patient mortality. While there has been increased attention to safety in medicine since the Institute of Medicine publication To Err is Human, the profession at large has not progressed to the same degree as other highly complex industries such as aviation ...

Diabetes mellitus is a disease with debilitating potential. Growing numbers of elderly individuals are being admitted to under-resourced nursing homes with this often complicated, time-intensive, and costly diagnosis. The purpose of this systematic review of the literature was to determine the trends in diabetes management in nursing homes over the ...

A post traumatic parotid sialocele is an acquired lesion that arises from extravasation of saliva into glandular or periglandular tissues secondary to disruption of the parotid duct or parenchyma. Facial trauma and surgery in the parotid region are the most common causes of this rare condition. This paper presents an ...

Background  Chemotherapy-induced nausea and vomiting is the commonest side-effect for patients undergoing cancer treatment with chemotherapy. These symptoms can lead to nutritional deficiencies, dehydration and electrolyte imbalance, and negative impacts on quality of life. However, wide gaps exist between clinician and patient perceptions of nausea and vomiting. Effective communication about ...

To highlight the significant impact breakthrough cancer pain (BTcP) can have on patients' quality of life and to discuss potential management strategies that could improve pain control in clinical practice as well as effective strategies to manage risk. BTcP can place a significant physical, psychological and economic burden on patients. ...

Objective: To determine the acceptance and attitudes of family medicine physicians, clinical and nonclinical office staff, pharmacists, and patients during pharmacist integration into a medical home.Design: Qualitative study.Setting: Pittsburgh, PA, area from August 2009 to June 2010.Participants: Physicians, staff, pharmacists, and patients at four single-specialty family medicine office practices functioning ...

Studies of the history and current status of forest resources in Northeast China have become important in discussions of sustainable forest management in the region. Prior to 1998, excessive logging and neglected cultivation led to a series of problems that left exploitable forest reserves in the region almost exhausted. A ...

Primary care providers (PCPs) provide the majority of weight management care in clinical settings; however, they often lack the time or resources to apply strategies recommended in treatment guidelines. This review surveyed randomized clinical trials and prospective weight management studies from 1990 to present to identify evidence-based behavioural strategies for ...

Traditional Chinese medicine (TCM), used in China and other Asian counties for thousands of years, is increasingly utilized in Western countries. However, due to inherent differences in how Western medicine and this ancient modality are practiced, employing the so-called Western medicine-based gold standard research methods to evaluate TCM is challenging. ...