This article was Dynamed’s pick for a recent article that would most likely change clinical practice. The article concludes: “Four readily available variables (acute respiratory compromise before admission: bruising of the torso, ears, or neck; bilateral or interhemispheric subdural hemorrhages or collections; and any skull fractures other than an isolated, unilateral, nondiastatic, linear, parietal fracture) identify AHT with high sensitivity in young, acutely head-injured children admitted to the PICU. (Pediatrics, Dec) Click here to read full-text.
News You Can Use
Consensus Guideline: ACR appropriateness criteria definitive external-beam irradiation in Stage T1 and T2 prostate cancerby jmiller on December 5, 2014
“External-beam radiation is a key component of the curative management of T1 and T2 prostate cancer. By combining the most recent medical literature and expert opinion, this guideline can aid physicians in the appropriate use of external-beam radiation for prostate cancer. The outcome for patients with localized prostate cancer depends on the aggressiveness of their disease, their natural life expectancy, and the efficacy and toxicity of the chosen therapy. In retrospective series, definitive EBRT for the treatment of stage T1 and T2 prostate cancer seems to be as effective as other treatments modalities. (e.g. radical prostatectomy and brachytherapy). (Am J Clin Oncol, June) Click here to read full-text.
Diagnosis of obstructive sleep apnea in adults: A clinical practice guideline from the American College of Physiciansby jmiller on December 5, 2014
This clinical practice guideline recommends 1: a sleep study for patients with unexplained daytime sleepiness, and 2: polysomnography for diagnostic testing in patients suspected of obstructive sleep apnea. ACP recommends portable sleep monitors in patients without serious comorbidities as an alternative to polysomnography when polysomnography is not available for diagnostic testing. (Ann Intern Med, Aug 5) Click here to read full text.
Nonsurgical management of urinary incontinence in women: A clinical practice guideline from the American College of Physiciansby jmiller on December 5, 2014
This practice guideline provides six recommendations for the nonsurgical management of urinary incontinence. “Urinary incontinence is a common and important health care problem in women that is underrported and underdiagnosed. Clinicians should use nonpharmacologic management for UI, such as pelvic floor muscle training (PFMT) for stress jurinary incontinence, bladder training for mixed urinary incontinence, because these therapies are effective, have few adverse effects, and are cheaper than pharmacolgic therapies. Although pharmacologic therapy can improve UI and provide complete continence, many patients discontinue medication because of adverse effects. (Ann Intern Med, Sept) Click here to read full text.
Clinical practice guidelines for the management of pain, agitation and delirium in adult patients in the ICUby jmiller on December 5, 2014
These guidelines provide a roadmap for developing integrated, evidence-based, and patient-centered protocols for preventing and treating pain, agitation, and delirium in critically ill patients.(Crit Care Med, Jan 2013) Click here to view full-text.
Click here to read full-text on the CDC Guidelines regarding Ebola, including PPE donning and doffing.
These Practice Guidelines (Am Fam Phys, Aug) make the following key points: Treatment of stage A heart failure should focus on reducing modifiable risk factors, including management of hypertension and hyperlipidemia; To prevent symptomatic heart failure, ACE inhibitors and beta blockers hould be used in all patients with stage B or C heart failure who have a reduced ejection fraction; Patients with stage C heart failure and fluid retention should be treated with diuretics in addition to ACE inhibitors and beta blockers. Click here to read full text.