Search results for "Topic"
showing 10 items of 2844 documents
[Evidence-based emergency medicine].
1999
„Evidence Based Emergency Medicine” (EBEM) ist ein Begriff, der im Zusammenhang mit Qualitatsmanagement immer haufiger verwendet wird. Er soll letztlich zum Ausdruck bringen, das Effektivitat und Effizienz von Methoden, Verfahren, Medikationen etc. – wo immer moglich – durch wissenschaftliche Beweise (erhoben in kontrollierten Studien oder abgeleitet aus Metaanalysen, aber auch beruhend auf „State of the Art Reviews”) belegt werden mussen, bevor sie in die arztliche Praxis umgesetzt werden.Wo dies nicht oder nicht mehr moglich ist, mus versucht werden, die zugrundeliegenden diagnostischen und therapeutischen Prinzipien im Nachhinein zu validieren. Nur so kann die Lucke zwischen Forschung ei…
Dacriocistitis por Candida Lusitaniae
2007
espanolCaso clinico: Se presenta el caso de una mujer de 60 anos con episodios recurrentes de dacriocistitis aguda derecha que no cedian con tratamiento medico ni tras una dacriocistorrinostomia con intubacion bicanalicular. Presento tambien una dacriocistitis izquierda que requirio una dacriocistorrinostomia. Se tomaron muestras intraoperatorias y en el cultivo aparecio Candida Lusitaniae como germen responsable. Tras tratamiento topico con Anfotericina B, asociado a dacriocistorrinostomia, la clinica desaparecio. Discusion: La dacriocistitis por Candida Lusitaniae es muy rara. Cabria preguntarse si Candida Lusitaniae es el germen primario o la dacriocistitis podria ser por sobreinfeccion …
Botulinum Toxin Injection Plus Topical Diltiazem for Chronic Anal Fissure: A Randomized Double-Blind Clinical Trial and Long-term Outcome.
2021
BACKGROUND: Chemical sphincterotomy avoids the risk of permanent incontinence in the treatment of chronic anal fissure, but it does not reach the efficacy of surgery and recurrence is high. Drug combination has been proposed to overcome these drawbacks.; OBJECTIVE: This study aimed to compare the clinical, morphological, and functional effects of combined therapy with botulinum toxin injection and topical diltiazem in chronic anal fissure and to assess the long-term outcome after healing.; DESIGN: This is a randomized, controlled, double-blind, 2-arm, parallel-group trial with a long-term follow-up.; SETTINGS: This study was conducted at a tertiary care center.; PATIENTS: A total of 70 cons…
Human papillomaviruses in oral carcinoma and oral potentially malignant disorders: a systematic review.
2011
Human papillomavirus (HPV) in oral carcinoma (OSCC) and potentially malignant disorders (OPMD) is controversial. The primary aim was to calculate pooled risk estimates for the association of HPV with OSCC and OPMD when compared with healthy oral mucosa as controls. We also examined the effects of sampling techniques on HPV detection rates. Methods: Systematic review was performed using PubMed (January 1966-September 2010) and EMBASE (January 1990-September 2010). Eligible studies included randomized controlled, cohort and cross-sectional studies. Pooled data were analysed by calculating odds ratios, using a random effects model. Risk of bias was based on characteristics of study group, appr…
MASked-unconTrolled hypERtension management based on office BP or on ambulatory blood pressure measurement (MASTER) Study: a randomised controlled tr…
2018
Introduction Masked uncontrolled hypertension (MUCH) carries an increased risk of cardiovascular (CV) complications and can be identified through combined use of office (O) and ambulatory (A) blood pressure (BP) monitoring (M) in treated patients. However, it is still debated whether the information carried by ABPM should be considered for MUCH management. Aim of the MASked-unconTrolled hypERtension management based on OBP or on ambulatory blood pressure measurement (MASTER) Study is to assess the impact on outcome of MUCH management based on OBPM or ABPM. Methods and analysis MASTER is a 4-year prospective, randomised, open-label, blinded-endpoint investigation. A total of 1240 treated hyp…
Smoking cessation opportunities in severe mental illness (tobacco intensive motivational and estimate risk — TIMER—): study protocol for a randomized…
2019
There is an increased risk of premature death in people with severe mental illness (SMI). Respiratory disorders and cardiovascular disease are leading causes of increased mortality rates in these patients, and tobacco consumption remains the most preventable risk factor involved. Developing new tools to motivate patients towards cessation of smoking is a high priority. Information on the motivational value of giving the lung age and prevention opportunities is unknown in this high-risk population. In the context of community care, screening and early detection of lung damage could potentially be used, together with mobile technology, in order to produce a prevention message, which may provi…
Overcoming barriers to evidence-based patient blood management: a restricted review
2020
Abstract Background Blood transfusions are associated with a range of adverse patient outcomes, including coagulopathy, immunomodulation and haemolysis, which increase the risk of morbidity and mortality. Consideration of these risks and potential benefits are necessary when deciding to transfuse. Patient blood management (PBM) guidelines exist to assist in clinical decision-making, but they are underutilised. Exploration of barriers to the implementation and utilisation of the PBM guidelines is required. This study aimed to identify common barriers and implementation strategies used to implement PBM guidelines, with a comparison against current expert opinion. Methods A restricted review a…
Cardiovascular risk in patients without known cardiovascular disease.
2014
Understanding the risks of atherosclerotic cardiovascular disease (CVD) allows for better patient education and management. Multiple risk models have been validated in large patient populations and provide insights into the risks associated with CVD. When assessing such risks, we suggest using a model that predicts myocardial infarction, cardiovascular death, and/or cerebrovascular events. In this review, we analyze several risk models and stratify the risks associated with CVD. We suggest that appropriate profiling of patients at-risk of CVD will lead to better physician recognition and treatment of modifiable risk factors, appropriate application of ATP III treatment for hyperlipidemia, a…
Factors Associated With Loneliness: An Umbrella Review Of Observational Studies.
2020
Background: Evidence provides inconsistent findings on risk factors and health outcomes associated with loneliness. The aim of this work was to grade the evidence on risk factors and health outcomes associated with loneliness, using an umbrella review approach. Methods: For each meta-analytic association, random-effects summary effect size, 95% confidence intervals (CIs), heterogeneity, evidence for small-study effect, excess significance bias and 95% prediction intervals were calculated, and used to grade significant evidence (p<0.05) from convincing to weak. For narrative systematic reviews, findings were reported descriptively. Results: From 210 studies initially evaluated, 14 publica…
Hearing impairment and diverse health outcomes: An umbrella review of meta-analyses of observational studies
2021
Background: Globally, it is estimated that approximately 1.3 billion people live with some form of hearing impairment. Major causes of hearing loss include infection/disease, age-related factors, and occupational factors. Numerous systematic reviews and meta-analyses have attempted to synthesise literature on these topics. To date there has not been a systematic evaluation of the relationships between hearing impairment and diverse physical, mental, and social outcomes. Objective: We performed an umbrella review of systematic reviews of observational studies with meta-analyses for any physical disease, biomarkers of disease, mental health or cognitive outcomes, and/or modifiable risk factor…