3,790 research outputs found

    Management of diabetes from preconception to the postnatal period: summary of NICE guidance

    Get PDF
    Diabetes in pregnancy is associated with risks to the woman (for example, higher rates of miscarriage, preeclampsia, and preterm labour) and to the developing fetus and baby (for example, higher rates of congenital malformations, macrosomia, birth injury, and perinatal mortality). This article summarises the most recent guidance from the National Institute for Health and Clinical Excellence (NICE) on how to manage diabetes and its complications from preconception to the postnatal period

    ESHRE guideline : endometriosis

    Get PDF
    STUDY QUESTION: How should endometriosis be diagnosed and managed based on the best available evidence from published literature? SUMMARY ANSWER: The current guideline provides 109 recommendations on diagnosis, treatments for pain and infertility, management of disease recurrence, asymptomatic or extrapelvic disease, endometriosis in adolescents and postmenopausal women, prevention and the association with cancer. WHAT IS KNOWN ALREADY: Endometriosis is a chronic condition with a plethora of presentations in terms of not only the occurrence of lesions, but also the presence of signs and symptoms. The most important symptoms include pain and infertility. STUDY DESIGN, SIZE, DURATION: The guideline was developed according to the structured methodology for development of ESHRE guidelines. After formulation of key questions by a group of experts, literature searches and assessments were performed. Papers published up to 1 December 2020 and written in English were included in the literature review. PARTICIPANTS/MATERIALS, SETTING, METHODS: Based on the collected evidence, recommendations were formulated and discussed within specialist subgroups and then presented to the core guideline development group (GDG) until consensus was reached. A stakeholder review was organized after finalization of the draft. The final version was approved by the GDG and the ESHRE Executive Committee. MAIN RESULTS AND THE ROLE OF CHANCE: This guideline aims to help clinicians to apply best care for women with endometriosis. Although studies mostly focus on women of reproductive age, the guideline also addresses endometriosis in adolescents and postmenopausal women. The guideline outlines the diagnostic process for endometriosis, which challenges laparoscopy and histology as gold standard diagnostic tests. The options for treatment of endometriosis-associated pain symptoms include analgesics, medical treatments and surgery. Non-pharmacological treatments are also discussed. For management of endometriosis-associated infertility, surgical treatment and/or medically assisted reproduction are feasible. While most of the more recent studies confirm previous ESHRE recommendations, there are five topics in which significant changes to recommendations were required and changes in clinical practice are to be expected. LIMITATIONS, REASONS FOR CAUTION: The guideline describes different management options but, based on existing evidence, no firm recommendations could be formulated on the most appropriate treatments. Also, for specific clinical issues, such as asymptomatic endometriosis or extrapelvic endometriosis, the evidence is too scarce to make evidence-based recommendations. WIDER IMPLICATIONS OF THE FINDINGS: The guideline provides clinicians with clear advice on best practice in endometriosis care, based on the best evidence currently available. In addition, a list of research recommendations is provided to stimulate further studies in endometriosis.Peer reviewe

    Clinical Practice Guidelines for Dementia in Australia: A step towards improving uptake of research findings in health and aged-care settings

    Get PDF
    This author accepted manuscript (post print) is made available following a 12 month embargo form date of publication (21 April 2016) in accordance with the publisher copyright policy

    Smoking cessation

    Get PDF
    "Treating Tobacco Use and Dependence: 2008 Update, a Public Health Service- sponsored Clinical Practice Guideline, is a product of the Tobacco Use and Dependence Guideline Panel ("the Panel"), consortium representatives, consultants, and staff. These 37 individuals were charged with the responsibility of identifying effective, experimentally validated tobacco dependence treatments and practices. The updated Guideline was sponsored by a consortium of eight Federal Government and nonprofit organizations: the Agency for Healthcare Research and Quality (AHRQ); Centers for Disease Control and Prevention (CDC); National Cancer Institute (NCI); National Heart, Lung, and Blood Institute (NHLBI); National Institute on Drug Abuse (NIDA); American Legacy Foundation; Robert Wood Johnson Foundation (RWJF); and University of Wisconsin School of Medicine and Public Health's Center for Tobacco Research and Intervention (UW-CTRI). This Guideline is an updated version of the 2000 Treating Tobacco Use and Dependence: Clinical Practice Guideline that was sponsored by the U.S. Public Health Service, U. S. Department of Health and Human Services. An impetus for this Guideline update was the expanding literature on tobacco dependence and its treatment. The original 1996 Guideline was based on some 3,000 articles on tobacco treatment published between 1975 and 1994. The 2000 Guideline entailed the collection and screening of an additional 3,000 articles published between 1995 and 1999. The 2008 Guideline update screened an additional 2,700 articles; thus, the present Guideline update reflects the distillation of a literature base of more than 8,700 research articles. Of course, this body of research was further reviewed to identify a much smaller group of articles."- p. v1. Overview and methods. -- 2. Assessment of tobacco use -- 3. Clinical interventions for tobacco use and dependence.. -- 4. Intensive interventions for tobacco use and dependence. -- 5. Systems interventions--mportance to health care administrators, insurers, and purchasers. -- 6. Evidence and recommendations.. -- 7. Specific populations and other topics. -- Appendix A. Financial disclosure for panel members, liaisons, and peer reviewers -- Appendix B. Helpful Web site addresses -- Appendix C. Coding information regarding the diagnosis of and billing for tobacco dependence treatment -- Appendix D. Key recommendation changes From the 2000 PHS-sponsored clinical practice guideline: treating tobacco use and dependenceMichael C. Fiore (panel chair) ... [et al.]."May 2008."Available on the Internet as an Acrobat .pdf file (2.04 MB, 276 p.).Mode of access: Internet from the Office of the Surgeon General web site. Address as of 5/16/08: http://www.surgeongeneral.gov/tobacco/.Bibliographical references listed at www.surgeongeneral.gov/tobacco/gdlnrefs.ht
    corecore