This scientifice statement from the American Hear Association (Circulation, Dec 2014) provides an up-to-date overview of the postthrombotic syndrome (PTS), a frequent, chronic complication of deep venous thrombosis (DVT), and to provide practical recommendations for its optimal prevention, diagnosis, and management. The intended audience for this scientific statement includes clinicians, and other healthcare professionals caring for patients with DVT. Click here to read full text.
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This guideline (J Clin Endocrinol Metab, Dec 14) recommends “that plain radiographs be obtained of the pertinent regions of the skeleton in patients with suspected Paget’s disease. If the diagnosis is confirmed, we suggest that a radionucleotide bone scan be done to determine the extent of the disease. After diagnosis of Paget’s disease, we recommend measurement of serum total alkaline phosphatase or, when warranted, a more specific marker of bone formation or bone resorption to assess the response to treatment or evolution of the disease in untreated patients. We suggest treatment with besphosphonate for most patients with active Paget’s disease who are at risk for future complications, Click here to read full text.
The article concludes: “Use of a stringent protocol to treat NAS, regardless of the initial opioid chosen, reduces the duration of opioid exposure and length of hospital stay. Because the major driver of cost is length of hospitalization, the implications for a reduction in cost of care for NAS management could be substantial. (Pediatrics, Aug 2014) Click here to read full-text.
Extending strict rest to 5 days from 1-2 days may not improve symptoms in children with mild concussionby jmiller on January 16, 2015
In an early online (Jan 5th) article from Pediatrics, there may be no benefit to an extended period of strict rest for children after mild traumatic brain injury or concussin. In fact, symptom reporting was increased in children who were recommended extended rest. Strict rest was defined as no school, work or physical activity followed by a stepwise return to normal activities. Children admitted to the hospital were excluded from the analysis. Click here to read full text.
This is an evidence-based review of the diagnosis, staging and treatment of CLL. “Chemoimmunotherapy is the standard first-line option approach for CLL, the most common leukemia observed in adults. Treatment is initiated when the disease becomes symptomatic, and survival is high following treatment.” (JAMA, Dec 3) Click here to read full-text.
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.
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.