Search results for "Approach"

Comprehensive management of risk factors in peripheral vascular disease. Expert consensus

2020

There is currently a degree of divergence among the main clinical practice guidelines on the management of risk factors for peripheral arterial disease (PAD). This project aims to gain understanding of the management of PAD risk factors in clinical practice and to reach a multidisciplinary consensus on the strategies to be followed in order to optimize its identification, treatment, and follow-up.A multidisciplinary consensus following the Delphi methodology.Professionals (n = 130) with extensive experience in PAD participated in this consultation. The results suggest that in order to optimize the control of risk factors, efforts should be aimed at: (1) promoting the involvement and awarene…

Rektumprolaps bei Erwachsenen - Ursache, Diagnostik, Therapie

2005

Despite progress in modern surgery, the choice of the surgical procedure of rectal prolapse is regarded with controversy. Selection criteria between the abdominal or perineal approach or between rectopexy and resection rectopexy are not yet proven. This article gives a review of the literature about rectal prolapse and an analysis of the outcome of posterior rectopexy and resection rectopexy--partly conventionally and partly laparoscopically--in 25 patients with rectal prolapse III degrees and IV degrees. All except for one patient were examined during a mean follow-up of 5.5 (3.1) years for the rectopexy group and 2.1 (0.7) years for the resection rectopexy group. Recurrence occurred in on…

PRACTICAL RECOMMENDATIONS FOR THE MANAGEMENT OF PATIENTS WITH ITP DURING THE COVID-19 PANDEMIC

2021

The current COVID-19 pandemic requires revisiting our current approach to major blood disorders, including ITP (Immune Thrombocytopenia), stirring  up the production of several disease-specific practical guidelines. This report describes an updated version of consensus-based practical guidelines on the management of ITP, adapted to the Italian health system and social context.  It highlights the role of the hematologist in offering guidance for choosing differentiated approaches in relation to specific circumstances and is intended to provide them with a useful tool for sharing the decision-making process with their patients.
 Probably, the greatest risk to avoid for a patient with sus…

A Roadmap to the Pelvic Autonomic Nerves During Transanal Dissection

2019

Current international guidelines and consensus panels emphasize that nerve sparing is a crucial part of the total mesorectal excision (TME). The transanal approach (taTME) could be advantageous in this regard. However, even with taTME, pelvic autonomic nerve preservation requires perfect knowledge of the topographic and morphological aspects of the anatomy and requires surgeons to acquire specific skills. Unusual surgical topography presents a considerable risk of nerve injury, when attempting a TME with the “bottom-up” approach.

Positive Effect of Steroids in Posterior Reversible Encephalopathy Syndrome

2019

We present a case of posterior reversible encephalopathy syndrome with severe clinical manifestation. Apart from initial aphasia, hemiparesis, and a generalized seizure, the patient had a prolonged loss of consciousness. Although blood pressure was normalized, the clinical status deteriorated continuously. After adding steroids to the therapy, the patient recovered rapidly, suggesting that this could have been a useful therapeutic approach. Even the vasogenic edema in the cerebral magnetic resonance imaging disappeared shortly within 6 days.

Guiding Principles for Chronic Total Occlusion Percutaneous Coronary Intervention. A Global Expert Consensus Document

2019

© American Heart Association, Inc.

A review of settings-based health promotion with applications to sports clubs.

2013

Sports clubs have a long and tradit ional history in many countries, ye t they remain underdeveloped and underutilized settings for health promotion. Leisure ti me settings, in general, have been in minor role among settings-based health promotion initiatives. Curre nt health concerns in western countries, such as sedentary lifestyles and obesity, have aroused a need to expand he alth promotion to include also settings with greater potential to reach and engage children and adoles cents in more vigorous activity. To develop these alternative, most often non-institutiona l, settings to the level of the established ones, it is important to review what has been done, what ha s been accepted, a…

The multidisciplinary management of gastro-oesophageal junction tumours

2016

Abstract Background and scope The management of GOJ cancers remains controversial and may vary between countries. Evidence-based attitudes and guidelines are not easy to elaborate since most of the trials and studies reported mixed cases of oesophageal (both adenocarcinoma and squamous cell tumours), GOJ and gastric cancers. The aim of this expert discussion and position paper is to elaborate practical recommendations that integrate evidence-reported literature and experience-based attitude covering all clinical aspects of GOJ cancer across different specialities and countries in Europe. Methodology Opinion leaders, selected on scientific merit were asked to answer to a prepared set of ques…

Clinical scoring systems for predicting outcome after surgery for colorectal liver metastases: towards a better multidisciplinary approach

2009

Transperitoneal vs retroperitoneal minimally invasive partial nephrectomy: comparison of perioperative outcomes and functional follow-up in a large m…

2020

Abstract Background Aim of this study was to evaluate and compare perioperative outcomes of transperitoneal (TP) and retroperitoneal (TR) approaches in a multi-institutional cohort of minimally invasive partial nephrectomy (MI-PN). Material and methods All consecutive patients undergone MI-PN for clinical T1 renal tumors at 26 Italian centers (RECORd2 project) between 01/2013 and 12/2016 were evaluated, collecting the pre-, intra-, and postoperative data. The patients were then stratified according to the surgical approach, TP or RP. A 1:1 propensity score (PS) matching was performed to obtain homogeneous cohorts, considering the age, gender, baseline eGFR, surgical indication, clinical dia…