Italian guidelines for primary headaches: 2012 revised version

The first edition of the Italian diagnostic and therapeutic guidelines for primary headaches in adults was published in J Headache Pain 2(Suppl. 1):105–190 (2001). Ten years later, the guideline committee of the Italian Society for the Study of Headaches (SISC) decided it was time to update therapeutic guidelines. A literature search was carried out on Medline database, and all articles on primary headache treatments in English, German, French and Italian published from February 2001 to December 2011 were taken into account. Only randomized controlled trials (RCT) and meta-analyses were analysed for each drug. If RCT were lacking, open studies and case series were also examined. According to the previous edition, four levels of recommendation were defined on the basis of levels of evidence, scientific strength of evidence and clinical effectiveness. Recommendations for symptomatic and prophylactic treatment of migraine and cluster headache were therefore revised with respect to previous 2001 guidelines and a section was dedicated to non-pharmacological treatment. This article reports a summary of the revised version published in extenso in an Italian version

Diabetic ketoacidosis

Diabetic ketoacidosis (DKA) is the most common acute hyperglycaemic emergency in people with diabetes mellitus. A diagnosis of DKA is confirmed when all of the three criteria are present — ‘D’, either elevated blood glucose levels or a family history of diabetes mellitus; ‘K’, the presence of high urinary or blood ketoacids; and ‘A’, a high anion gap metabolic acidosis. Early diagnosis and management are paramount to improve patient outcomes. The mainstays of treatment include restoration of circulating volume, insulin therapy, electrolyte replacement and treatment of any underlying precipitating event. Without optimal treatment, DKA remains a condition with appreciable, although largely preventable, morbidity and mortality. In this Primer, we discuss the epidemiology, pathogenesis, risk factors and diagnosis of DKA and provide practical recommendations for the management of DKA in adults and children

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Using Net Wetland Loss, Current Wetland Condition, and Planned Future Watershed Condition for Wetland Conservation Prioritization, Tampa Bay Watershed, Florida

The Tampa Bay Watershed is emblematic of moderately sized coastal watersheds in the US: one-third of the wetlands were lost between the 1950s and 2007; numerous wetland remain, though many have been impacted; most remaining wetlands are hydrologically connected to downgradient waters; there are future constraints to wetland conservation; and the spatial complexity of these factors make it difficult to coordinate watershed-scale wetland conservation planning. Therefore, the Tampa Bay Watershed can serve as a model system for studying coordinated watershed-scale wetland conservation planning. The development of a technical framework requires that spatially explicit information be obtained, analyzed, and organized so customizable queries can be run by stakeholder agencies. Our approach does so by using readily available data to create a geodatabase organized into a set of screening layers that can be intersected hierarchically to identify areas where wetland preservation and restoration might be best used to accomplish overarching goals. Our approach was developed in conjunction with stakeholder input and is currently being integrated into a coordinated watershed-scale wetland conservation effort

Using Net Wetland Loss, Current Wetland Condition, and Planned Future Watershed Condition for Wetland Conservation Planning and Prioritization, Tampa Bay Watershed, Florida

The Tampa Bay Watershed is emblematic of moderately sized coastal watersheds in the US, particularly along the Gulf Coast: one-third of the wetlands were lost between the 1950s and 2007; numerous wetland remain, though many have been impacted; most of the remaining wetlands are hydrologically connected to downstream wetlands and waterbodies; there are future constraints to wetland conservation; and the spatial complexity of these factors make it difficult to coordinate watershed-scale wetland conservation planning. Therefore, the Tampa Bay Watershed can serve as a model system for studying ways to coordinate watershed-scale wetland conservation planning efforts. The development of a technical framework to support coordinated, watershed-scale wetland conservation planning requires that spatially explicit information be obtained, analyzed, and organized so customizable queries can be run by stakeholder agencies. The approach described herein does so by using readily available data to create a geodatabase organized into a set of screening layers that can be intersected hierarchically to identify areas where wetland preservation and restoration might be best used to accomplish overarching goals. The information and tools described herein were developed in conjunction with stakeholder input and are in the process of being integrated into a watershed master plan for freshwater wetland conservation