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Compliance with Atypical Antipsychotic Triage guidelines by Texas Poison Centers

JOURNAL OF MEDICAL TOXICOLOGY 2010年第4期6卷 403-407页

作者： Forrester, Mathias B. Dept State Hlth Serv Epidemiol & Dis Surveillance Unit 1100 W 49th St Austin TX 78756 USA

Triage guidelines for poison center management of atypical antipsychotic ingestions were published in December 2007. This investigation determined whether Texas poison centers already complied with a simplified version of these guidelines. All acute aripiprazole, clozapine, olanzapine, quetiapine, risperidone, and ziprasidone ingestions reported to Texas poison centers during 2000-2007 were identified. Exclusion criteria were the presence of coingestants, patient already at or en route to a healthcare facility when the poison center was contacted, and chronic ingestion. Each case was evaluated whether it was managed in compliance with the simplified triage guidelines and the compliance rate calculated. For 2,611 total cases, the compliance rate was 64.1%. The rate was 71.7% for aripiprazole, 43.6% for clozapine, 71.6% for olanzapine, 60.8% for quetiapine, 65.5% for risperidone, and 59.0% for ziprasidone. The majority of acute atypical antipsychotic ingestions reported to Texas poison centers were managed according to a simplified version of recommended triage algorithm.

关键词： Atypical antipsychotic management guidelines Poison center

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A Survey of the distributed network management models and architectures: Assessment and Challenges

A Survey of the distributed network management models and ar...

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6th IEEE International Conference on Adaptive Science and Technology (ICAST)

作者： Soidridine, Moussa Moindze Karim, Konate UCAD Dept Math & Comp Sci Dakar Senegal

ISBN: (纸本)9781479949984

In this work, we'll strive to present a survey about the important traditional and modern telecommunication management network (TMN) on one hand;and information and communication technology (ICT) management on the other hand. In this review, we classify all the major networks and technology management systems known to date in order to provide guidelines for network management architectures design. This paper shows an assessment of the current technology management in terms of models, architectures and methods. This assessment allowed us to trace out their strengths and weaknesses according to the managing of the next generation networks. We are going to build a taxonomy based on three-criteria for all these technologies, especially the new ones. The main guidelines for the proposal of innovative architectures to be able to control the emerging networks of the 21st century requirements are addressed.

关键词： management models management architectures management methods Network management vision management problems management guidelines management challenges NGN NGNM

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Family still matters: Counseling patients with complex family histories of colon and endometrial cancers

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MOLECULAR GENETICS & GENOMIC MEDICINE 2019年第9期7卷 e886页

作者： Gemmell, Amber P. Mauer, Caitlin B. Reys, Brian D. Pirzadeh-Miller, Sara Rosso, Theodora S. UT Southwestern Med Ctr Simmons Comprehens Canc Ctr Dallas TX USA UT Southwestern Med Ctr Dept Internal Med Dallas TX USA

Background There are no national guidelines for the management of patients with a family history consistent with Lynch syndrome (LS) but a negative genetic test. To determine current management practices, genetic counselors' (GCs) recommendations were assessed. Methods A survey of GCs using five hypothetical pedigrees was posted to National Society of Genetic Counselors (NSGC) discussion forums. Descriptive statistics were used. Results One-hundred and fifteen surveys were completed. A pedigree with a first-degree relative (FDR) with early-onset colorectal cancer (CRC) and a family history of CRC and endometrial cancer (EC) prompted 83% (n = 95) of respondents to recommend early and frequent colonoscopies, based on family history. When the CRCs and ECs occurred in family members removed from the proband, 96% (n = 110) of GCs said they would screen based on family history. However, only 52% (n = 60) suggested CRC screening should begin earlier and occur more often, and 43% (n = 50) suggested CRC screening should follow standard age and frequency guidelines. Conclusion Concordance of opinion among GCs for the management of patients with negative genetic test results exists when FDRs are affected. However, when affected relatives are more distant, GCs disagreed on screening recommendations. These data suggest a need for guidelines for patients with a family history of cancer and a negative genetic test.

关键词： colon cancer endometrial cancer genetic counseling Lynch syndrome management guidelines

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The Role of Movement Patterns in Epidemic Models on Complex Networks

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BULLETIN OF MATHEMATICAL BIOLOGY 2021年第10期83卷 98-98页

作者： Ruiz-Herrera, Alfonso Torres, Pedro J. Univ Oviedo Fac Sci Dept Math Oviedo Spain Univ Granada Fac Sci Dept Appl Math Granada Spain

In this paper, we analyze the influence of the usual movement variables on the spread of an epidemic. Specifically, given two spatial topologies, we can deduce which topology produces less infected individuals. In particular, we determine the topology that minimizes the overall number of infected individuals. It is worth noting that we do not assume any of the common simplifying assumptions in network theory such as all the links have the same diffusion rate or the movement of the individuals is symmetric. Our main conclusion is that the degree of mobility of the population plays a critical role in the spread of a disease. Finally, we derive theoretical insights to management of epidemics.

关键词： Optimal topology Degree of mobility management guidelines Patchy models

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The role of the spatial topology in trophic metacommunities: Species with reduced mobility and total population size

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JOURNAL OF THEORETICAL BIOLOGY 2023年 566卷 111479页

作者： Ruiz-Herrera, Alfonso Univ Oviedo Dept Math Oviedo Spain

A central question in ecology is understanding the influence of the spatial topology on the dynamics of a metacommunity. This is not an easy task, as most fragmented ecosystems have trophic interactions involving many species and patches. Recent attempts to solve this challenge have introduced certain simplifying assumptions or focused on a limited set of examples. These simplifications make the models mathematically tractable but keep away from real-world problems. In this paper, we provide a novel methodology to describe the influence of the spatial topology on the total population size of the species when the dispersal rates are small. The main conclusion is that the influence of the spatial topology is the result of the influence of each path in isolation. Here, a path refers to a pairwise connection between two patches. Our framework can be readily used with any metacommunity, and therefore represents a unification of biological insights. We also discuss several applications regarding the construction of ecological corridors.

关键词： Additive influence Population abundance management guidelines Spatial topology Metacommunities

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Addressing the need for patient-friendly medical communications: adaptation of the 2019 recommendations for the management of MPS VI and MPS IVA

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ORPHANET JOURNAL OF RARE DISEASES 2022年第1期17卷 91-91页

作者： Bruce, Iain A. Ezgu, Fatih S. Kampmann, Christoph Kenis, Vladimir Mackenzie, William Stevens, Bob Walker, Robert Hendriksz, Christian Manchester Acad Hlth Serv MAHSC Royal Manchester Childrens Hosp Dept Paediat Otolaryngol Manchester Lancs England Gazi Univ Dept Pediat Metab Unit Ankara Turkey Johannes Guterberg Univ Univ Childrens Hosp Div Cardiol Mainz Germany H Turner Natl Med Res Ctr Childrens Orthoped & Tr Dept Foot & Ankle Surg Neuroorthopaed & Skeletal St Petersburg Russia Dupont Hosp Children Dept Orthoped Nemours Alfred 1 Wilmington DE USA MPS Soc Amersham Bucks England Royal Manchester Childrens Hosp Dept Paediat Anaesthesia Manchester Lancs England Univ Pretoria Steve Biko Acad Unit Dept Pediat Pretoria South Africa

Background Patients are the most important stakeholders in the care of any disease and have an educational need to learn about their condition and the treatment they should receive. Considering this need for patient-focused materials, we present a directed approach for mucopolysaccharidosis (MPS) VI and MPS IVA, a pair of rare, inherited diseases that affects multiple organs and parts of the body. Independent guidelines on the treatment of these diseases were recently published, providing evidence- and expertise-driven recommendations to optimize patient management. However, while healthcare providers may have the training and knowledge to understand these guidelines, patients and their caregivers can find the technical content challenging. Hence, we aimed to develop plain language summaries (PLS) of the MPS VI and MPS IVA guidelines with patients as the primary audience. Results A review of the guidelines by an expert team identified six domains of information relevant to patients: The multidisciplinary team, regular tests and check-ups, disease-modifying and supportive treatments, general anesthetics, ear-nose-throat/respiratory care, and surgeries. This information was adapted into a series of infographics specific to either MPS VI or MPS IVA, designed to appeal to patients and clearly present information in a concise manner. Conclusions The use of patient-friendly materials, like the infographics we have developed, has the potential to better inform patients and engage them in their care. We issue a "call to arms" to the medical community for the development of similar PLS materials in rare diseases intended to inform and empower patients.

关键词： Rare diseases Mucopolysaccharidosis MPS IVA MPS VI management guidelines Enzyme replacement therapy Surgery Anesthetics Patient engagement Patient education

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Changing paradigms of hemophilia care across larger specialized treatment centers in the European region

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THERAPEUTIC ADVANCES IN HEMATOLOGY 2022年 13卷 20406207221088462页

作者： Windyga, Jerzy Boban, Ana Zupan, Irena O'Connell, Niamh Hermans, Cedric Inst Hematol & Transfus Med Lab Hemostasis & Metab Dis Dept Hemostasis Disorders & Internal Med PL-02776 Warsaw Poland Univ Zagreb Haemophilia Ctr Univ Hosp Ctr Zagreb Sch Med Zagreb Croatia Univ Ljubljana Dept Haematol Univ Med Ctr Ljubljana Fac Med Ljubljana Slovenia St James Hosp Natl Coagulat Ctr Dublin Ireland Trinity Coll Dublin Dublin Ireland Univ Catholique Louvain UCLouvain Hemostasis & Thrombosis Unit Div Hematol Clin Univ St Luc Brussels Belgium

Introduction: In early 2021, the European Collaborative Haemophilia Network (ECHN) conducted a survey to determine whether the paradigms of care across the European region have changed with the introduction of novel therapies for people with hemophilia. Methods: We conducted a survey in 19 ECHN centers from 17 countries in the European region. The aim was to track recent changes in the hemophilia treatment landscape, determine the impact of these changes on hemophilia treatment centers and comprehensive care centers in the region, and to look into the future of care as applied to people with hemophilia. The survey was structured to include three key areas: demographics and organization;current challenges and opportunities;and future directions. Discussion: Our survey provides a snapshot of the current approach to hemophilia treatment that highlights a move toward preventive, rather than reactive care, but that also raises a number of key concerns related to costs and accessibility (particularly as related to novel therapies), time limitations for clinical research, and ongoing issues regarding human resources (particularly in terms of new doctors entering the field) and availability of laboratory resources as the use of novel therapies (some with unique modes of action and unusual adverse events, some with specialized monitoring requirements) becomes commonplace. Conclusion: While our survey suggests that specialized care will continue to play a central role in the management of hemophilia, the standards and protocols, as well as the centers themselves, will have to continue to evolve if they are to continue to provide the highest level of care. To meet this requirement, there is a clear need for engaging, ongoing education programs for healthcare professionals working in the field of hemophilia that can be adjusted to the changing landscape of hemophilia therapy and monitoring.

关键词： Bleeding disorders emicizumab gene therapy hemophilia hemophilia treatment centers management guidelines novel hemophilia therapies outcomes prophylaxis treatment

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Recommendations for the management of MPS VI: systematic evidence- and consensus-based guidance

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ORPHANET JOURNAL OF RARE DISEASES 2019年第1期14卷 118-118页

作者： Akyol, Mehmet Umut Alden, Tord D. Amartino, Hernan Ashworth, Jane Belani, Kumar Berger, Kenneth I. Borgo, Andrea Braunlin, Elizabeth Eto, Yoshikatsu Gold, Jeffrey I. Jester, Andrea Jones, Simon A. Karsli, Cengiz Mackenzie, William Marinho, Diane Ruschel McFadyen, Andrew McGill, Jim Mitchell, John J. Muenzer, Joseph Okuyama, Torayuki Orchard, Paul J. Stevens, Bob Thomas, Sophie Walker, Robert Wynn, Robert Giugliani, Roberto Harmatz, Paul Hendriksz, Christian Scarpa, Maurizio Hacettepe Univ Dept Otolaryngol Ankara Turkey Northwestern Univ Ann & Robert H Lurie Childrens Hosp Chicago Feinberg Sch Med Dept Neurosurg Chicago IL 60611 USA Hosp Univ Austral Child Neurol Dept Buenos Aires DF Argentina Manchester Univ NHS Fdn Trust Manchester Royal Eye Hosp Dept Paediat Ophthalmol Manchester Lancs England Univ Minnesota Dept Anesthesiol Minneapolis MN 55455 USA NYU Sch Med Dept Med Bellevue HospAndre Cournand Pulm Physiol Lab New York NY USA NYU Sch Med Dept Neurosci Bellevue HospAndre Cournand Pulm Physiol Lab New York NY USA NYU Sch Med Dept Physiol Bellevue HospAndre Cournand Pulm Physiol Lab New York NY USA Padova Univ Hosp Orthopaed Clin Padua Italy Univ Minnesota Div Pediat Cardiol Minneapolis MN USA Inst Neurol Disorders Adv Clin Res Ctr Kawasaki Kanagawa Japan Tokyo Jikei Univ Sch Med Dept Paediat Gene Therapy Tokyo Japan Childrens Hosp Los Angeles Dept Anesthesiol Crit Care Med Keck Sch Med Dept Anesthesiol 4650 Sunset Blvd Los Angeles CA 90027 USA Childrens Hosp Los Angeles Dept Anesthesiol Crit Care Med Keck Sch Med Dept Pediat 4650 Sunset Blvd Los Angeles CA 90027 USA Childrens Hosp Los Angeles Dept Anesthesiol Crit Care Med Keck Sch Med Dept Psychiat & Behav Sci 4650 Sunset Blvd Los Angeles CA 90027 USA Birmingham Womens & Childrens Hosp Dept Plast Surg Hand & Upper Limb Serv Birmingham W Midlands England Manchester Univ NHS Fdn Trust St Marys Hosp Manchester Ctr Genom Med Willink Biochem Genet Unit Manchester Lancs England Hosp Sick Children Dept Anesthesiol & Pain Med Toronto ON Canada Nemours Alfred I Dupont Hosp Children Dept Orthoped Wilmington DE USA Univ Fed Rio Grande do Sul Dept Ophthalmol Porto Alegre RS Brazil HCPA Ophthalmol Serv Porto Alegre RS Brazil Isaac Fdn Campbellford ON Canada Queensland Childrens Hosp Dept Metab Med Brisbane Qld Australia Montreal Childrens Hosp Div Pediat Endocrinol Montreal PQ Canada Univ N Carolina Sch Med Dept Pediat Chapel Hill

IntroductionMucopolysaccharidosis (MPS) VI or Maroteaux-Lamy syndrome (253200) is an autosomal recessive lysosomal storage disorder caused by deficiency in N-acetylgalactosamine-4-sulfatase (arylsulfatase B). The heterogeneity and progressive nature of MPS VI necessitates a multidisciplinary team approach and there is a need for robust guidance to achieve optimal management. This programme was convened to develop evidence-based, expert-agreed recommendations for the general principles of management, routine monitoring requirements and the use of medical and surgical interventions in patients with MPS ***26 international healthcare professionals from various disciplines, all with expertise in managing MPS VI, and three patient advocates formed the Steering Committee group (SC) and contributed to the development of this guidance. Members from six Patient Advocacy Groups (PAGs) acted as advisors and attended interviews to ensure representation of the patient perspective. A modified-Delphi methodology was used to demonstrate consensus among a wider group of healthcare professionals with expertise and experience managing patients with MPS VI and the manuscript has been evaluated against the validated Appraisal of guidelines for Research and Evaluation (AGREE II) instrument by three independent *** total of 93 guidance statements were developed covering five domains: (1) general management principles;(2) recommended routine monitoring and assessments;(3) enzyme replacement therapy (ERT) and hematopoietic stem cell transplantation (HSCT);(4) interventions to support respiratory and sleep disorders;(5) anaesthetics and surgical interventions. Consensus was reached on all statements after two rounds of voting. The greatest challenges faced by patients as relayed by consultation with PAGs were deficits in endurance, dexterity, hearing, vision and respiratory function. The overall guideline AGREE II assessment score obtained for the development of the gui

关键词： Maroteaux-Lamy syndrome Mucopolysaccharidosis MPS VI management guidelines Galsulfase Enzyme replacement therapy ERT Haematopoietic stem cell transplantation HSCT Surgery Anaesthetics

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Revised Danish guidelines for the cancer surveillance of patients with Cowden Syndrome

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EUROPEAN JOURNAL OF MEDICAL GENETICS 2020年第5期63卷 103873-103873页

作者： Smerdel, Maja Patricia Skytte, Anne-Bine Jelsig, Anne Marie Ebbehoj, Eva Stochholm, Kirstine Univ Hosp Southern Denmark Lillebaelt Hosp Dept Clin Genet Kabbeltoft 25 DK-7100 Vejle Denmark Aarhus Univ Hosp Dept Clin Epidemiol Aarhus Denmark Copenhagen Univ Hosp Rigshosp Kennedy Ctr Clin Genet Clin Copenhagen Denmark Aarhus Univ Hosp Dept Internal Med & Diabet Aarhus Denmark Aarhus Univ Hosp Ctr Rare Dis Dept Pediat Aarhus Denmark Aarhus Univ Hosp Dept Internal Med & Diabet Aarhus Denmark

Introduction: Cowden syndrome is a cancer predisposition syndrome caused by pathogenic variants in PTEN. The affected patients possess an increased risk of breast, thyroid, renal, colorectal, endometrial cancers as well as malignant melanoma. Thus prophylactic surveillance and follow up is crucial for these patients. Methods: A review of the literature including existing guidelines from the years 1996 until 2017 was carried out. In total, 2078 scientific papers were identified through database searches on Cowden syndrome. Among these, 11 manuscripts were included based on scientific relevance and quality. Expert consensus was reached to define management guidelines. Results: The literature revealed a high risk of cancer in specific organs for patients diagnosed with Cowden Syndrome. Alternative management guidelines were proposed and discussed. Conclusions: Here we propose a revised set of management guidelines for patients with Cowden syndrome in Denmark to address the increased risk of various cancer types.

关键词： Cowden syndrome PTEN management guidelines Cancer

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Global best practices consensus: Long-term management of patients with hybrid centrifugal flow left ventricular assist device support

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JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2022年第4期164卷 1120-+页

作者： Hayward, Christopher Adachi, Iki Baudart, Sylvie Davis, Erin Feller, Erika D. Kinugawa, Koichiro Klein, Liviu Li, Song Lorts, Angela Mahr, Claudius Mathew, Jacob Morshuis, Michiel Mueller, Marcus Ono, Minoru Pagani, Francis D. Pappalardo, Federico Rich, Jonathan Robson, Desiree Rosenthal, David N. Saeed, Diyar Salerno, Christopher Sauer, Andrew J. Schloeglhofer, Thomas Tops, Laurens VanderPluym, Christina St Vincents Hosp Heart Failure & Transplant Unit Sydney NSW Australia St Vincents Hosp Heart Transplant Program Sydney NSW Australia Texas Childrens Hosp Baylor Coll Med Congenital Heart Surg Houston TX 77030 USA Univ Calif San Francisco Med Ctr Dept Mech Circulatory Support San Francisco CA USA Univ Calif San Francisco Med Ctr Div Cardiol San Francisco CA USA Univ Utah Hlth Transplant Serv Line Salt Lake City UT USA MedStar Hlth & Vasc Inst Baltimore MD USA Univ Toyama Dept Internal Med 2 Toyama Japan Univ Washington Div Cardiol Seattle WA USA Cincinnati Childrens Hosp Med Ctr Div Pediat Cardiol Cincinnati OH USA Royal Childrens Hosp Dept Cardiol Melbourne Vic Australia Heart & Diabet Ctr Dept Cardiothorac Surg Nrw Bad Oeynhausen Germany German Heart Ctr Berlin Dept Cardiothorac & Vasc Surg Berlin Germany Univ Tokyo Dept Cardiac Surg Tokyo Japan Univ Michigan Dept Cardiac Surg Ann Arbor MI USA AO SS Antonio & Biagio & Cesare Arrigo Dept CardioThorac & Vasc Anesthesia & Intens Alessandria Italy Northwestern Univ Feinberg Sch Med Dept Med Div Cardiol Chicago IL USA Stanford Univ Dept Pediat Palo Alto CA USA Lucille Packard Childrens Hosp Palo Alto CA 94304 USA Univ Dept Cardiac Surg Leipzig Heart Ctr Leipzig Germany Univ Chicago Med Dept Surg Chicago IL USA Univ Kansas Dept Cardiovasc Med Sch Med Kansas City KS USA Med Univ Vienna Dept Cardiac Surg Vienna Austria Leiden Univ Heart & Lung Ctr Med Ctr Leiden Netherlands Harvard Sch Med Heart Ctr Boston Childrens Hosp Boston MA USA

Objectives: Six months after withdrawal of the HeartWare HVAD System (HVAD;Medtronic) from sale, approximately 4000 patients continue ongoing support with this device. In light of the diminishing experience, this global consensus document summarizes key management recommendations. Methods: International experts with experience in the management of patients with ongoing HVAD support were invited to summarize key aspects of patient and pump management and highlight differences in the current HeartMate 3 (Abbott Laboratories) ventricular assist device. Clinicians from high-implanting HVAD sites reviewed current literature and reported experience to generate a consensus statement. Results: Specific guidelines to assist in the management of ongoing HVAD patients are developed. Key management protocols and helpful techniques developed from experienced clinicians are combined into a short guideline document. As experience with HeartMate 3 increases, key differences in approach to management are highlighted, where appropriate. Conclusions: With decreasing worldwide experience in the ongoing management of HVAD-supported patients, this consensus guideline provides a summary of best practice techniques from international centers. Differences in HeartMate 3 management are highlighted.

关键词： HeartWare HVAD left ventricular assist device blood pressure anticoagulation adverse events management guidelines

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