Canadian Guidelines for the Management of Plaque Psoriasis: Overview

2011 ◽  
Vol 15 (4) ◽  
pp. 210-219 ◽  
Author(s):  
Kim Papp ◽  
Wayne Gulliver ◽  
Charles Lynde ◽  
Yves Poulin ◽  
John Ashkenas
Keyword(s):  
Plaque Psoriasis ◽  
Treatment Guidelines ◽  
Treatment Recommendations ◽  
Clinical Treatment ◽  
Evidence Based ◽  
Corporate Sponsors

New clinical treatment guidelines for plaque psoriasis, written by a panel of 16 Canadian dermatologists, were recently published online. These Canadian Guidelines for the Management of Plaque Psoriasis are evidence based and free of any influence from corporate sponsors and have been endorsed by the Canadian Dermatology Association (CDA). The Guidelines offer treatment recommendations for mild and moderate to severe body psoriasis, as well as for psoriasis affecting specific areas of the skin, such as the facial, flexural, and genital areas; nails; scalp; and palms and soles. The present overview describes the genesis and contents of the Guidelines, which are available in full through the CDA at (English) or (French).

scholarly journals Hip fracture treatment in Norway

2020 ◽  
Vol 1 (10) ◽  
pp. 644-653
Author(s):  
Cato Kjærvik ◽  
Eva Stensland ◽  
Hanne Sigrun Byhring ◽  
Jan-Erik Gjertsen ◽  
Eva Dybvik ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Hip Fractures ◽  
Best Practice ◽  
Treatment Guidelines ◽  
Treatment Recommendations ◽  
Femoral Neck Fractures ◽  
Evidence Based ◽  
Fracture Treatment ◽  
One Year

Aims The aim of this study was to describe variation in hip fracture treatment in Norway expressed as adherence to international and national evidence-based treatment guidelines, to study factors influencing deviation from guidelines, and to analyze consequences of non-adherence. Methods International and national guidelines were identified and treatment recommendations extracted. All 43 hospitals routinely treating hip fractures in Norway were characterized. From the Norwegian Hip Fracture Register (NHFR), hip fracture patients aged > 65 years and operated in the period January 2014 to December 2018 for fractures with conclusive treatment guidelines were included (n = 29,613: femoral neck fractures (n = 21,325), stable trochanteric fractures (n = 5,546), inter- and subtrochanteric fractures (n = 2,742)). Adherence to treatment recommendations and a composite indicator of best practice were analyzed. Patient survival and reoperations were evaluated for each recommendation. Results Median age of the patients was 84 (IQR 77 to 89) years and 69% (20,427/29,613) were women. Overall, 79% (23,390/29,613) were treated within 48 hours, and 80% (23,635/29,613) by a surgeon with more than three years’ experience. Adherence to guidelines varied substantially but was markedly better in 2018 than in 2014. Having a dedicated hip fracture unit (OR 1.06, 95%CI 1.01 to 1.11) and a hospital hip fracture programme (OR 1.16, 95% CI 1.06 to 1.27) increased the probability of treatment according to best practice. Surgery after 48 hours increased one-year mortality significantly (OR 1.13, 95% CI 1.05 to 1.22; p = 0.001). Alternative treatment to arthroplasty for displaced femoral neck fractures (FNFs) increased mortality after 30 days (OR 1.29, 95% CI 1.03 to 1.62)) and one year (OR 1.45, 95% CI 1.22 to 1.72), and also increased the number of reoperations (OR 4.61, 95% CI 3.73 to 5.71). An uncemented stem increased the risk of reoperation significantly (OR 1.23, 95% CI 1.02 to 1.48; p = 0.030). Conclusion Our study demonstrates a substantial variation between hospitals in adherence to evidence-based guidelines for treatment of hip fractures in Norway. Non-adherence can be ascribed to in-hospital factors. Poor adherence has significant negative consequences for patients in the form of increased mortality rates at 30 and 365 days post-treatment and in reoperation rates. Cite this article: Bone Joint Open 2020;1-10:644–653.

The Red Legs RATED tool to improve diagnosis of lower limb cellulitis in the emergency department

2021 ◽  
Vol 30 (12) ◽  
pp. S22-S29
Author(s):  
Gillian O'Brien ◽  
Patricia White
Keyword(s):  
Emergency Department ◽  
Lower Limb ◽  
Treatment Guidelines ◽  
Positive Impact ◽  
Data Gathering ◽  
Pilot Project ◽  
Accurate Diagnosis ◽  
Evidence Based ◽  
Significant Burden ◽  
User Friendly

Background: Lower limb cellulitis poses a significant burden for the Irish healthcare system. Accurate diagnosis is difficult, with a lack of validated evidence-based tools and treatment guidelines, and difficulties distinguishing cellulitis from its imitators. It has been suggested that around 30% of suspected lower limb cellulitis is misdiagnosed. An audit of 132 patients between May 2017 and May 2018 identified a pattern of misdiagnosis in approximately 34% of this cohort. Objective: The aim of this pilot project was to develop a streamlined service for those presenting to the emergency department with red legs/suspected cellulitis, through introduction of the ‘Red Leg RATED’ tool for clinicians. Method: The tool was developed and introduced to emergency department clinicians. Individuals (n=24) presenting with suspected cellulitis over 4 weeks in 2018 were invited to participate in data gathering. Finally, clinician questionnaire feedback regarding the tool was evaluated. Results: Fourteen participants consented, 6 female and 8 male with mean age of 65 years. The tool identified 50% (n=7) as having cellulitis, of those 57% (n=4) required admission, 43% (n=3) were discharged. The remainder who did not have cellulitis (n=7) were discharged. Before introduction of the tool, all would typically have been admitted to hospital for further assessment and management of suspected lower limb cellulitis. Overall, 72% (n=10) of patients who initially presented with suspected cellulitis were discharged, suggesting positive impact of the tool. Clinician feedback suggested all were satisfied with the tool and contents. Conclusion: The Red Leg RATED tool is user friendly and impacts positively on diagnosis treatment and discharge. Further evaluation is warranted.

scholarly journals Conformance to Evidence-Based Treatment Recommendations in Schizophrenia Treatment Services

2012 ◽  
Vol 57 (5) ◽  
pp. 317-323 ◽  
Author(s):  
Donald Addington ◽  
Emily McKenzie ◽  
Harvey Smith ◽  
Henry Chuang ◽  
Stephen Boucher ◽  
...  
Keyword(s):  
Treatment Recommendations ◽  
Evidence Based ◽  
Evidence Based Treatment ◽  
Treatment Services

scholarly journals Az orvos–beteg kommunikáció jelentősége a szomatizáló páciensek ellátásában

2016 ◽  
Vol 157 (17) ◽  
pp. 664-668
Author(s):  
Adrienne Stauder ◽  
Dániel Eörsi ◽  
János Pilling
Keyword(s):  
Stress Reduction ◽  
Secondary Care ◽  
Medical Training ◽  
Treatment Guidelines ◽  
Somatic Symptoms ◽  
Somatic Complaints ◽  
Evidence Based ◽  
Medical Visits ◽  
Structured Intervention ◽  
As Stress

The term “somatization” refers to the manifestation of multiple somatic complaints not explained by organic changes. According to the literature, 15–25 percent of all medical visits are related to somatization. As medical training does not put enough emphasis on the evaluation of the possible psychological background of certain somatic symptoms, physicians may feel powerless and make unjustified diagnostic and therapeutic efforts. The patients may also feel helpless and frustrated, their anxiety and the intensity of their complaints may increase. As stress is an important factor in the somatization process, stress reduction and improvement of coping are key elements of the treatment guidelines for chronic diseases. Evidence based interventions range from short counselling and medication to cognitive and behavioral psychotherapy. Reattribution, a short (10–30 minutes) structured intervention that can be implemented in primary or secondary care, in certain cases can result in significant decrease in somatic symptoms and anxiety. Orv. Hetil., 2016, 157(17), 664–668.

scholarly journals Authors’ response to “Tranexamic acid and uremic bleeding: evidence-based treatment recommendations”

2007 ◽  
Vol 3 (6) ◽  
pp. E3-E3 ◽  
Author(s):  
Stephanie J Hedges ◽  
Sarah B Dehoney ◽  
Justin S Hooper ◽  
Jamshid Amanzadeh ◽  
Anthony J Busti
Keyword(s):  
Tranexamic Acid ◽  
Treatment Recommendations ◽  
Evidence Based ◽  
Evidence Based Treatment
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