Search results for "de-escalation"

Management of febrile neutropenia in the perspective of antimicrobial de-escalation and discontinuation.

2019

Introduction: Infections are among the most frequent complications in patients with hematological and oncological diseases. They might be classified as fever of unknown origin and microbiologically or clinically documented infections. Optimal duration of antimicrobial treatment is still unclear in these patients.Areas covered: We provide an overview on the management of febrile neutropenia in the perspective of antimicrobial de-escalation and discontinuation.Expert opinion: Patients with febrile high-risk neutropenia should be treated empirically with an anti-pseudomonal agent such as piperacillin/tazobactam. Several clinical studies support the assumption that the primary antibiotic regime…

A new approach to ticagrelor-based de-escalation of antiplatelet therapy after acute coronary syndrome. A rationale for a randomized, double-blind, p…

2021

The risk of ischemic events gradually decreases after acute coronary syndrome (ACS), reaching a stable level after 1 month, while the risk of bleeding remains steady during the whole period of dual antiplatelet treatment (DAPT). Several de-escalation strategies of antiplatelet treatment aiming to enhance safety of DAPT without depriving it of its efficacy have been evaluated so far. We hypothesized that reduction of the ticagrelor maintenance dose 1 month after ACS and its continuation until 12 months after ACS may improve adherence to antiplatelet treatment due to better tolerability compared with the standard dose of ticagrelor. Moreover, improved safety of treatment and preserved anti-is…

Empiric Antibiotics in Hospitalized Pneumonia: Discontinuation Is Better than De-escalation

2021

First Interim Analysis of the Italian Dante Study: De-Escalation before Treatment-Free Remission in Patients with Chronic Myeloid Leukemia Treated wi…

2021

Abstract Introduction: Treatment-free remission (TFR) in chronic myeloid leukemia (CML) is demonstrated to be achievable and recommended for patients (pts) in sustained deep molecular response (sDMR) who can discontinue tyrosine kinase inhibitor (TKI) treatment and maintain responses in ~50% of cases. While the feasibility and safety of TKI cessation have been largely demonstrated, the strategies of TFR optimization are yet to be clarified. Studies (eg. DESTINY) investigating de-escalation, mainly after imatinib, suggested that a stepwise approach may favor TFR outcome. We present the interim results of the phase 2, prospective, multicenter DANTE study (NCT03874858) evaluating de-escalation…

Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure : the DIANA study

2020

© 2020 The Author(s).

Modeling the escalation/de-escalation of response operation levels in disaster response networks using hierarchical Colored Petri Nets (CPN) approach

2018

In emergency situations, the first responders need to act promptly to situations, while the disaster management authorities' response might not be at the same speed. Delays by disaster management authorities had a direct impact on response operations led response teams to the shift away from command and control structures to net-centric ones. This paper is part of a study to examine patterns of emerging organizational relations and coordination structures in disaster response operations. Understanding coordination patterns in disaster chaos can help to integrate those patterns in the planning and execution in the modern disaster management operations. We use dynamic modeling methods to anal…

Delivery of Health Care by Spanish Dental Hygienists in Private and Public Dental Services during the COVID-19 De-Escalation Phase (June 2020): A Cro…

2021

Background: The first wave of the COVID-19 pandemic in Spain posed a major challenge for Spanish dental professionals. The objective of this work is to describe the dental hygienists’ work status and employment patterns during the de-escalation phase in order to analyse the standards of knowledge, compliance with official recommendations, and dental activities both in the public health service and in the private sector. Material and Methods: A cross-sectional questionnaire was answered by Spanish dental hygienists via WhatsApp, Facebook, and Instagram. The questionnaire was piloted before it was distributed and carried out during June 2020. Results: Here, 517 dental hygienists were surveyed…

Triple therapy de-escalation to dual bronchodilation in COPD patients: Baseline data from the DACCORD cohort

2020

Background: GOLD recommends triple therapy only in COPD patients with frequent exacerbations despite long-acting bronchodilators who exhibit a high blood eosinophil level (≥300/μL). Indication for ICS containing therapy should be reassessed regularly. Methods: The German real life study DACCORD included COPD patients who had received free triple therapy for ≥ 6 months prior to study entry. At baseline, patients were switched to LABA+LAMA fixed-dose combination (FDC) or maintained triple therapy upon discretion of the treating physician. Here, we compare baseline data of the 2 groups. Results: 1182 patients were recruited into DACCORD of which 30.7% were moved to LABA+LAMA FDC. Patients in t…

Assessment and management of agitation in psychiatry: Expert consensus

2016

International audience; BACKGROUND:Psychomotor agitation is associated with different psychiatric conditions and represents an important issue in psychiatry. Current recommendations on agitation in psychiatry are not univocal. Actually, an improper assessment and management may result in unnecessary coercive or sedative treatments. A thorough and balanced review plus an expert consensus can guide assessment and treatment decisions.METHODS:An expert task force iteratively developed consensus using the Delphi method. Initial survey items were based on systematic review of the literature. Subsequent surveys included new, re-worded or re-rated items.RESULTS:Out of 2175 papers assessing psychomo…