scholarly journals CUA guideline:Vasectomy

2016 ◽  
Vol 10 (7-8) ◽  
pp. 274 ◽  
Author(s):  
Armand Zini ◽  
John Grantmyre ◽  
Peter Chan
Keyword(s):  
Failure Rate ◽  
Evidence Based ◽  
Extensive Literature ◽  
Motile Sperm ◽  
Early Failure ◽  
Adequate Information ◽  
Late Failure ◽  
Elective Procedure ◽  
Fascial Interposition ◽  
Careful Assessment

<p>Vasectomy is a safe and effective method of birth control. Although it is a simple elective procedure, vasectomy is associated with potential minor and major complications. The early failure rate of vasectomy (presence of motile sperm in the ejaculate at 3‒6 months post-vasectomy) is in the range of 0.3‒9% and the late failure rate is in the range of 0.04–0.08%. The no-scalpel vasectomy technique is associated with a lower risk of early postoperative complications and the use of cautery or fascial interposition will reduce the risk of contraceptive failure. As such, detailed preoperative counselling and careful assessment of the post-vasectomy ejaculate (for presence of sperm) is imperative. Failure to provide and document adequate information and counselling to patients may lead to litigation.</p><p>The focus of this guideline is the management of men presenting for vasectomy. Specifically, the topics covered include: preoperative counselling, vasectomy efficacy and complications, technical aspects of vasectomy, post-vasectomy semen testing, and interpretation-communication of post-vasectomy semen results. By performing an extensive literature review, we have generated an evidence-based consensus on the management of these men. The objective of this guideline is to help standardize the treatment of men presenting for vasectomy.</p>

Abstraction: An alternative neurocognitive account of recognition, prediction, and decision making

2020 ◽  
Vol 43 ◽  
Author(s):  
Valerie F. Reyna ◽  
David A. Broniatowski
Keyword(s):  
Decision Making ◽  
Software Engineering ◽  
Systems Engineering ◽  
Evidence Based ◽  
Extensive Literature ◽  
Trace Theory ◽  
Fuzzy Trace Theory ◽  
Abstract Representations ◽  
Technical Systems

Abstract Gilead et al. offer a thoughtful and much-needed treatment of abstraction. However, it fails to build on an extensive literature on abstraction, representational diversity, neurocognition, and psychopathology that provides important constraints and alternative evidence-based conceptions. We draw on conceptions in software engineering, socio-technical systems engineering, and a neurocognitive theory with abstract representations of gist at its core, fuzzy-trace theory.

Developing an Evidence-Based Clinical Decision-Support System to Enhance Prosthetic Prescription

2021 ◽  
Vol 10 (1) ◽  
pp. 121-125
Author(s):  
Pratima Saravanan ◽  
Jessica Menold
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Decision Support System ◽  
Gait Analysis ◽  
Support System ◽  
Patient Specific ◽  
Evidence Based ◽  
Extensive Literature ◽  
Analysis Tool ◽  
Care Providers

With the rapid increase in the global amputee population, there is a clear need to assist amputee care providers with their decision-making during the prosthetic prescription process. To achieve this, an evidence-based decision support system that encompasses existing literature, current decision-making strategies employed by amputee care providers and patient-specific factors is proposed. Based on an extensive literature review combined with natural language processing and expert survey, the factors influencing the current decision-making of amputee care providers in prosthetic prescription were identified. Following that, the decision-making strategies employed by expert and novice prosthetists were captured and analyzed. Finally, a fundamental understanding of the effect gait analysis has on the decision-making strategies of prosthetists was studied. Findings from this work lay the foundation for developing a real-time decision support system integrated with a portable gait analysis tool to enhance prescription processes. This is critical in the low-income countries where there is a scarcity of amputee care providers and resources for an appropriate prescription.

Translating Evidence-Based Interventions Into Practice

2011 ◽  
Vol 12 (6_suppl_1) ◽  
pp. 9S-19S ◽  
Author(s):  
Meera Viswanathan ◽  
Linda Lux ◽  
Kathleen N. Lohr ◽  
Tammeka Swinson Evans ◽  
Lucia Rojas Smith ◽  
...  
Keyword(s):  
Health Care Providers ◽  
System Integration ◽  
Pediatric Asthma ◽  
Evidence Based ◽  
Extensive Literature ◽  
Care Providers ◽  
Planning Period ◽  
Community Based ◽  
Asthma Morbidity ◽  
Effective Interventions

Pediatric asthma is a multifactorial disease, requiring complex, interrelated interventions addressing children, families, schools, and communities. The Merck Childhood Asthma Network, Inc. (MCAN) is a nonprofit organization that provides support to translate evidence-based interventions from research to practice. MCAN developed the rationale and vision for the program through a phased approach, including an extensive literature review, stakeholder engagement, and evaluation of funding gaps. The analysis pointed to the need to identify pediatric asthma interventions implemented in urban U.S. settings that have demonstrated efficacy and materials for replication and to translate the interventions into wider practice. In addition to this overall MCAN objective, specific goals included service and system integration through linkages among health care providers, schools, community-based organizations, patients, parents, and other caregivers. MCAN selected sites based on demonstrated ability to implement effective interventions and to address multiple contexts of pediatric asthma prevention and management. Selected MCAN program sites were mature institutions or organizations with significant infrastructure, existing funding, and the ability to provide services without requiring a lengthy planning period. Program sites were located in communities with high asthma morbidity and intended to integrate new elements into existing programs to create comprehensive care approaches.

scholarly journals Paper # 106: The Low Contact Stress Patellofemoral Arthroplasty – High Early Failure Rate

2011 ◽  
Vol 27 (10) ◽  
pp. e138-e139
Author(s):  
Paul M. Sutton ◽  
Bambos Charalambous ◽  
Simon Mills ◽  
Zain Abiddin Z ◽  
Shaun Rogers ◽  
...  
Keyword(s):  
Failure Rate ◽  
Contact Stress ◽  
Patellofemoral Arthroplasty ◽  
Early Failure ◽  
Low Contact Stress

Comparison of postal and non-postal post-vasectomy semen sample submission strategies on compliance and failures: an 11-year analysis of the audit database of the Association of Surgeons in Primary Care of the UK

2021 ◽  
pp. bmjsrh-2021-201064
Author(s):  
Melanie Atkinson ◽  
Gareth James ◽  
Katie Bond ◽  
Zoe Harcombe ◽  
Michel Labrecque
Keyword(s):  
Primary Care ◽  
Semen Analysis ◽  
Failure Detection ◽  
Semen Sample ◽  
Failure Rates ◽  
Early Failure ◽  
Detection Rates ◽  
Late Failure ◽  
The Difference ◽  
The Uk

BackgroundVasectomy occlusive success is defined by the recommendation of ‘clearance’ to stop other contraception, and is elicited by post-vasectomy semen analysis (PVSA). We evaluated how the choice of either a postal or non-postal PVSA submission strategy was associated with compliance to PVSA and effectiveness of vasectomy.MethodsWe studied vasectomies performed in the UK from 2008 to 2019, reported in annual audits by Association of Surgeons in Primary Care members. We calculated the difference between the two strategies for compliance with PVSA, and early and late vasectomy failure. We determined compliance by adding the numbers of men with early failure and those given clearance. We performed stratified analyses by the number of test guidance for clearance (one-test/two-test) and the study period (2008–2013/2014–2019).ResultsAmong 58 900 vasectomised men, 32 708 (56%) and 26 192 (44%) were advised submission by postal and non-postal strategies, respectively. Compliance with postal (79.5%) was significantly greater than with non-postal strategy (59.1%), the difference being 20.4% (95% CI 19.7% to 21.2%). In compliant patients, overall early failure detection was lower with postal (0.73%) than with non-postal (0.94%) strategy (−0.22%, 95% CI −0.41% to −0.04%), but this difference was neither clinically nor statistically significant with one-test guidance in 2014–2019. There was no difference in late failure rates.ConclusionsPostal strategy significantly increased compliance to PVSA with similar failure detection rates. This resulted in more individuals receiving clearance or early failure because of the greater percentage of postal samples submitted. Postal strategy warrants inclusion in any future guidelines as a reliable and convenient option.

Evidence-based guidelines for acute stabilization and management of neonates with persistent pulmonary hypertension of the newborn

2021 ◽  
Author(s):  
Molly K Ball ◽  
Ruth Seabrook ◽  
Elizabeth M Bonachea ◽  
Bernadette Chen ◽  
Omid Fathi ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Neonatal Intensive Care ◽  
Best Practice ◽  
Clinical Care ◽  
Persistent Pulmonary Hypertension ◽  
High Morbidity ◽  
Evidence Based ◽  
Extensive Literature ◽  
Disciplinary Expertise ◽  
Evidence Based Guidelines

Persistent pulmonary hypertension of the newborn, or PPHN, represents a challenging condition associated with high morbidity and mortality. Management is complicated by complex pathophysiology and limited neonatal specific evidence-based literature, leading to a lack of universal contemporary clinical guidelines for the care of these patients. To address this need and to provide consistent high-quality clinical care for this challenging population in our neonatal intensive care unit, we sought to develop a comprehensive clinical guideline for the acute stabilization and management of neonates with PPHN. Utilizing cross-disciplinary expertise and incorporating an extensive literature search to guide best practice, we present an approachable, pragmatic, and clinically relevant guide for the bedside management of acute PPHN.

Pediatric Tracheostomy Decannulation: 11-Year Experience

2019 ◽  
Vol 161 (3) ◽  
pp. 499-506 ◽  
Author(s):  
Kristen L. Seligman ◽  
Bryan J. Liming ◽  
Richard J. H. Smith
Keyword(s):  
Failure Rate ◽  
Chart Review ◽  
Pediatric Patients ◽  
Demographic Data ◽  
Tertiary Care ◽  
Case Series ◽  
Late Failure ◽  
Final Study ◽  
Study Population ◽  
Tertiary Care Institution

Objective To determine the successful decannulation rate with a published pediatric tracheostomy decannulation protocol. Study Design Case series with chart review. Setting A single tertiary care institution. Subjects and Methods A chart review was performed for patients aged ≤5 years who underwent tracheostomy. Extracted data included demographic data, indication for tracheostomy, age at tracheostomy and decannulation, comorbidities, and surgical complications. Records were searched for documentation of early decannulation failure (within 1 month of decannulation) or late failure (within 1 year). Results Forty patients with a tracheostomy aged ≤5 years underwent attempted decannulation during the 11-year study period. Seventeen patients were excluded from the study for documentation of nonprotocol decannulation. The final study population of 23 patients underwent a total of 27 decannulations, 26 of which were performed by protocol. Of the 26 protocol decannulations, 22 were successful, for a failure rate of 15%. Conclusion Twenty-six protocol decannulations were attempted among 23 patients, 4 of which were unsuccessful for an overall failure rate of 15%. This result is consistent with rates reported in other published decannulation protocols. We believe that our protocol minimizes resource utilization in its use of pulse oximetry over polysomnography, while maximizing patient safety and success through the use of capping trials for very young and very small pediatric patients.

Operative angiography after femoropopliteal arterial reconstructionits influence on early failure rate

1968 ◽  
Vol 55 (2) ◽  
pp. 134-136 ◽  
Author(s):  
Stuart Renwick ◽  
John P. Royle ◽  
Peter Martin
Keyword(s):  
Failure Rate ◽  
Early Failure

scholarly journals High Early Failure Rate After Cementless Hip Replacement in the Octogenarian

2014 ◽  
Vol 472 (9) ◽  
pp. 2779-2789 ◽  
Author(s):  
Esa Jämsen ◽  
Antti Eskelinen ◽  
Mikko Peltola ◽  
Keijo Mäkelä
Keyword(s):  
Failure Rate ◽  
Hip Replacement ◽  
Early Failure

scholarly journals CUA Guideline: Management of ureteral calculi

2015 ◽  
Vol 9 (11-12) ◽  
pp. 837 ◽  
Author(s):  
Michael Ordon ◽  
Sero Andonian ◽  
Brian Blew ◽  
Trevor Schuler ◽  
Ben Chew ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Conservative Management ◽  
Treatment Success ◽  
Ureteral Stones ◽  
Shockwave Lithotripsy ◽  
Evidence Based ◽  
Extensive Literature ◽  
Factors Affecting ◽  
Medical Expulsive Therapy ◽  
Literature Reviews

The focus of this guideline is the management of ureteral stones. Specifically, the topics covered include: conservative management, medical expulsive therapy, active intervention with either shockwave lithotripsy (SWL) or ureteroscopy (URS), factors affecting SWL treatment success, optimizing success, and special considerations (e.g., pregnancy, urinary diversion). By performing extensive literature reviews for each topic evaluated, we have generated an evidence-based consensus on the management of ureteral stones. The objective of this guideline is to help standardize the treatment of ureteral stones to optimize treatment outcomes.

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