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Neonatal diabetes mellitus: Insulin pump as an alternative management strategy

JOURNAL OF PAEDIATRICS AND CHILD HEALTH 2005年第9-10期41卷 522-526页

作者： Bharucha, T Brown, J McDonnell, C Gebert, R McDougall, P Cameron, F Werther, G Zacharin, M Royal Childrens Hosp Dept Endocrinol & Diabet Parkville Vic 3052 Australia Murdoch Childrens Res Inst Ctr Hormone Res Parkville Vic Australia Royal Childrens Hosp Dept Neonatol Parkville Vic 3052 Australia

Neonatal diabetes mellitus (hyperglycaemia within the first month of life, with an insulin requirement) may be transient or permanent. management is complex, due to lack of subcutaneous fat and the need for small doses of insulin, and may be complicated by additional medical problems. Three cases are presented, the first of which was treated with conventional insulin therapy. The latter two were successfully treated with subcutaneous insulin pump therapy. We present suggested guidelines for treatment of neonatal diabetes, using this novel approach to management.

关键词： continuous subcutaneous insulin infusion diabetes mellitus management guidelines newborn

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Non-consensual recommendations for managing bipolar II disorder

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AUSTRALASIAN PSYCHIATRY 2020年第3期28卷 335-338页

作者： Parker, Gordon Univ NSW Sch Psychiat Sydney NSW Australia

Objective: The objective of this study is to report on the degree of consensus in experts' recommendations for managing bipolar II disorder. Methods: Eighteen international clinician researchers with expertise in managing bipolar disorders were provided with 14 questions addressing nuances in managing those with a bipolar II disorder. Results: To all questions, the independently derived recommended strategies demonstrated distinct divergence. Conclusion: The lack of consensus in management recommendations is likely to reflect the disorder being relatively recently formalised, the lack of condition-specific randomised controlled trial data and the nature of psychiatric practice.

关键词： bipolar disorder bipolar II disorder management guidelines

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An Invited Commentary on "Evidence Based management Guideline for the COVID-19 pandemic-Review article"

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INTERNATIONAL JOURNAL OF SURGERY 2020年 78卷 106-107页

作者： Atogebania, Julius Wedam Chen, Hualei Hainan Med Univ Affiliated Hosp 2 Dept Surg Haikou 570100 Hainan Peoples R China Hainan Med Univ Affiliated Hosp 2 Dept Urol Surg Haikou Hainan Peoples R China

COVID 19 been declared recently as a pandemic, to date has affected over 1,8881,365 with over 119,403 deaths in accordance to the global pandemic Real-Time Report. In this paper, the prime motive is to enlighten the key variables to the public on the pandemic and essential key points to note and practice in accordance to standard regulation to curb the aggressive COVID-19 pandemic.

关键词： SARS-CoV-2 COVID-19 Pandemic management guidelines

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The outcome of STOP-Hypertension-2 in relation to the 1999 WHO/ISH hypertension guidelines

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BLOOD PRESSURE 2000年第SUP2期9卷 21-24页

作者： Lindholm, LH Dept Publ Hlth & Clin Med Umea Sweden

The 1999 hypertension management guidelines issued by the World Health Organization and the International Society of Hypertension emphasize the importance of blood pressure reduction in the prevention of cardiovascular events. Furthermore, they conclude that the benefits of treatment are due to blood pressure lowering per sc, rather than to any specific antihypertensive therapy. The results of the second Swedish Trial in Old Patients with Hypertension (STOP-Hypertension-2) are consistent with these recommendations, since in this trial angiotensin converting enzyme (ACE) inhibitors and calcium antagonists reduced blood pressure to the same extent as conventional therapy with beta-blockers and diuretics in elderly hypertensive patients, and the three treatments produced similar reductions in the risk of cardiovascular events. Furthermore, a first subgroup analysis of cardiovascular mortality showed that the three treatments seemed equally effective in diabetic patients. The STOP-Hypertension-2 data, therefore, are fully consistent with the 1999 hypertension management guidelines, and underline the advantages offered by both older and newer antihypertensive therapies.

关键词： antihypertensive therapy management guidelines STOP-Hypertension-2 WHO/ISH guidelines

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Universal Clinician Device for improving risk prediction and management of patients with atrial fibrillation: an assumed benefit analysis

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EUROPEAN HEART JOURNAL - DIGITAL HEALTH 2022年第2期3卷 181-194页

作者： van Husen, Georg Virdone, Saverio Pieper, Karen Kayani, Gloria Fox, Keith A. A. Tenac Io Oberwallstr 6 D-10117 Berlin Germany Thrombosis Res Inst Dept Stat London England Univ Edinburgh Ctr Cardiovasc Sci Edinburgh Midlothian Scotland

Aim Atrial fibrillation (AF) management guidelines advise using risk tools to optimize AF treatment. This study aims to develop a dynamic and clinically applicable digital device to assess stroke and bleeding risk, and to facilitate outcome improvements in AF patients. The device will provide tailored treatment recommendations according to easily attainable individual patient data. Methods and Results This Universal Clinician Device (UCD) was created using the GARFIELD-AF registry using a split sample approach. The GARFIELD-AF risk tool was adapted with two modifications. First, predictors with >= 1000 missing data points were separated, allowing expected risks estimation. Second, recommendations for modifiable risk factors and associated 2-year outcome estimates were incorporated. Outcomes of interest were all-cause mortality, non-haemorrhagic stroke/systemic embolism (SE), and major bleeding. All patients were randomized to a derivation (n=34853) and validation cohort (n=17165). In the derivation cohort, predictors were identified using least absolute shrinkage and selection operator regression. Cox models were fitted with the selected parameters. The UCD demonstrated superior predictive power compared with CHA(2)DS(2)VASc for all-cause mortality [0.75(0.75-0.76) vs. 0.71(0.70-0.72)] and non-haemorrhagic stroke/SE [0.68(0.66-0.70) vs. 0.65(0.63-0.67)], and with HAS-BLED for major bleeding [0.69(0.67-0.71) vs. 0.64(0.62-0.65)]. Universal Clinician Device recommendations reduced all-cause mortality (8.45-5.42%) and non-haemorrhagic stroke/SE (2.58-1.50%). Patients with concomitant diabetes and chronic kidney disease benefitted further, reducing mortality risk from 13.15% to 8.67%. One-third of patients with a CHA(2)DS(2)VASc score of >1 had the lowest risk of stroke. Conclusion The UCD simultaneously predicts mortality, stroke, and bleeding risk in patients using easily attainable individual clinical data and guideline-based optimized treatment plans. Clinical Trial

关键词： Atrial fibrillation Universal Clinician Device management guidelines Diabetes Personalized medicine Risk prediction

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The European Endangered Species Programme (EEP) for the Hyacinth macaw from 1989 to 1998: Anodorhynchus hyacinthinus

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International Zoo Yearbook 2000年第1期37卷 178-183页

作者： LÜcker, H. Patzwahl, S. Zoo Dresden Dresden 01219 Tiergartenstrasse 1 Germany Pare Paradisio Cambron-Casteau B-7940 Domaine de Cambron Belgium

In 1989 the European Endangered Species Programme (EEP) for the Hyacinth macaw Anodorhynchus hyacinthinus was founded following concerns about the status of the wild population and the lack of breeding success in captivity. In 1993 management guidelines were developed and published, and these were revised in 1996 to bring them into line with EEP guidelines for other species. Problematic aspects of breeding, hand-rearing and diet are discussed, and several detailed guidelines to facilitate successful breeding in captivity are given. © 2017 Wiley. All rights reserved.

关键词： EEP Hyacinth macaw management guidelines Reproduction problems

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Traumatic brain injury in childhood. management in the emergency room

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TRAUMA UND BERUFSKRANKHEIT 2014年第2期16卷 190-196页

作者： Rothe, K. Fischer, B. Degenhardt, P. Charite Univ Med Berlin Klin & Poliklin Kinderchirurg Campus Virchow KlinikumAugustenburger Pl 1 D-13353 Berlin Germany

Background. Traumatic brain injury (TBI) is one of the most common injuries in childhood, but the assessment of mild TBI regarding further management varies significantly. Thus, a managment algorithm is required. Evaluation. Cranial computed tomography (cCT) is the method of choice for radiological examination. Without clear guidelines, many of these children may be exposed to excess radiation owing to unnecessary imaging. Conclusion. Implementation of a simple management guideline for the care of children with mild TBI can have a significant impact on cost and length of stay, while simultaneously reducing radiation exposure. Widespread implementation of such guidelines will improve efficiency without sacrificing quality of care in the management of mild TBI in the pediatric population.

关键词： Brain injuries Childhood Risk factors X-ray tomography, computed management guidelines

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A systematic review of guidelines for managing rheumatoid arthritis

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BMC RHEUMATOLOGY 2019年第1期3卷 1页

作者： Mian, Aneela Ibrahim, Fowzia Scott, David L. Kings Coll London Acad Rheumatol Dept Inflammat Biol Sch Immunol & Microbial SciWeston Educ Ctr Denmark Hill London SE5 9RT England

BackgroundWe systematically reviewed current guidelines for managing rheumatoid arthritis (RA) to evaluate their range and nature, assess variations in their recommendations and highlight divergence in their *** searched Medline and Embase databases using the terms 'clinical practice guidelines' and 'rheumatoid arthritis' from January 2000 to January 2017 together with publications of national and international bodies. We included guidelines providing recommendations on general RA management spanning a range of treatments and published in English. We undertook narrative assessments due to the heterogeneity of the *** identified 529 articles;22 met our inclusion criteria. They were primarily developed by rheumatologists with variable involvement of patient and other experts. Three dealt with early RA, one established RA and 18 all patients. Most guidelines recommend regular assessments based on the Outcome Measures in Rheumatology core dataset;18 recommended the disease activity score for 28 joints. Twenty recommended targeting remission;16 suggested low disease activity as alternative. All guidelines recommend treating active RA;13 made recommendations for moderate disease. The 21 guidelines considering early RA all recommended starting disease modifying drugs (DMARDs) as soon as possible;methotrexate was recommended for most patients. Nineteen recommended combination DMARDs when patients failed to respond fully to monotherapy and biologics were not necessarily indicated. Twenty made recommendations about biologics invariably suggesting their use after failing conventional DMARDs, particularly methotrexate. Most did not make specific recommendations about using one class of biologics preferentially. Eight recommended tapering biologics when patients achieved sustained good *** general principles transcend most guidelines: DMARDs should be started as soon as possible after the diagnosis;methotrexate is the bes

关键词： Rheumatoid arthritis Systematic review management guidelines

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Managing the burden of Type 2 diabetes: An international survey of physicians

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Practical Diabetes International 1997年第7期14卷 201-206页

作者： Southwell, A. Eckland, D. Glaxo Wellcome Research Develop Ltd Greenford UB6 0HE United Kingdom

This prospective, cross-sectional study was designed to gather information about the management of patients with Type 2 diabetes (NIDDM). It was conducted in three of the largest European healthcare providing countries: France, Germany and the UK. Three hundred and five physicians completed five sections of a diary card (covering aspects of workload, demography, treatment, condition and tests conducted) anonymously for 3043 pharmacologically-treated Type 2 patients attending for a consultation. The majority of the patient population were elderly, had had a long diagnosis of diabetes, were overweight and had several coexisting complications. Neuropathy, nephropathy and retinopathy were present in 23%, 24% and 15% of the patients, respectively. Concomitant cardiovascular risk factors such as hypertension, hypercholesterolaemia and ischaemic heart disease were present in 49%, 40% and 34% of patients, respectively. Fifty per cent of patients had undergone a change in therapy in the previous five years: the major reason being 'insufficient glycaemic control'. In the remainder, adverse effects of weight gain and hypoglycaemia were most commonly reported. This information provides an insight into the present and future clinical burden that diabetes places on patients, physicians and healthcare systems.

关键词： Healthcare resource Macrovascular and microvascular complications management guidelines Qualify of life Treatment Type 2 diabetes mellitus

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Oral Mucosal Injury in Oncology Patients

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Current Oral Health Reports 2014年第3期1卷 190-195页

作者： Peterson, Douglas E. Section of Oral Medicine Department of Oral Health & Diagnostic Sciences School of Dental Medicine University of Connecticut Health Center Farmington 06030-1605 CT United States Program in Head & Neck Cancer and Oral Oncology Neag Comprehensive Cancer Center University of Connecticut Health Center Farmington CT United States

The field of oral mucosal injury caused by cancer therapies has strategically matured in the scientific as well as clinical realms over the past decade. Prior to the late 1990s, the condition had been viewed by many healthcare providers as an inevitable consequence of high-dose chemotherapy and other intensive therapies in oncology practice. Fortunately, expanding insights into the pathobiology as well as design strategies for clinical trials in recent years have fostered development of high-quality clinical practice guidelines as well as health professional education relative to prevention and treatment. This report is directed to analysis of this contemporary modeling. Guideline-based management recommendations that have emerged over the past year and controversies in the field are highlighted. © 2014, Springer International Publishing AG.

关键词： management guidelines Oncology Oral mucosal injury Pathobiology

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