Search results for "evidence-based medicine"
showing 10 items of 228 documents
Prevention of Sports Injuries
2007
Increased participation in sports has led to more sports injuries. Evidence-based methods to prevent sports injuries are needed. A systematic review was conducted of the effects of randomized controlled interventions to prevent sports injuries. A systematic search was performed of various databases and the reference lists of articles and reviews. Two reviewers independently extracted the data and assessed the methodological quality of the included trials. Thirty-two trials (24,931 participants) met the inclusion criteria. We found evidence of the preventive effect of 3 types of injury prevention interventions. In 5 trials including 6 different comparisons (2446 participants), custom-made or…
Evidence-based Guidelines for the Management of Exocrine Pancreatic Insufficiency After Pancreatic Surgery
2016
Objective: To provide evidence-based recommendations for the management of exocrine pancreatic insufficiency (EPI) after pancreatic surgery. Background: EPI is a common complication after pancreatic surgery but there is certain confusion about its frequency, optimal methods of diagnosis, and when and how to treat these patients. Methods: Eighteen multidisciplinary reviewers performed a systematic review on 10 predefined questions following the GRADE methodology. Six external expert referees reviewed the retrieved information. Members from Spanish Association of Pancreatology were invited to suggest modifications and voted for the quantification of agreement. Results: These guidelines analyz…
COVID-19 and oral lesions, short communication and review
2021
Background The COVID-19 disease first appeared in December 2019 in Wuhan, China. The World Health Organization (WHO) declared the pandemic in March 2020, with 40 million cases and a million deaths in October 2020. COVID-19 also includes manifestations on the skin and mucous mucosal membrane. Objective: To evaluate the prevalence of the oral lesions associated to COVID-19 disease; and evaluate their clinical presentation and the hypothesized etiology. Material and methods An electronic literature search was performed in PubMed, Scopus and Indice Medico Espanol databases. The following combination of keywords and Boolean operators were used: "COVID-19 AND oral manifestations"; "COVID-19 AND o…
Pharmacologic management of neuropathic pain: Evidence-based recommendations
2007
Patients with neuropathic pain (NP) are challenging to manage and evidence-based clinical recommendations for pharmacologic management are needed. Systematic literature reviews, randomized clinical trials, and existing guidelines were evaluated at a consensus meeting. Medications were considered for recommendation if their efficacy was supported by at least one methodologically-sound, randomized clinical trial (RCT) demonstrating superiority to placebo or a relevant comparison treatment. Recommendations were based on the amount and consistency of evidence, degree of efficacy, safety, and clinical experience of the authors. Available RCTs typically evaluated chronic NP of moderate to severe …
The role of the renin-angiotensin system in atrial fibrillation and the therapeutic effects of ACE-Is and ARBS
2008
Atrial fibrillation (AF) is the most common rhythm disturbance in medical practice and represents a very expensive health problem. AF can be managed with the prevention of thromboembolism and either a rate control of rhythm strategy. As both strategies have important limitations, probably a preventative strategy in patients at risk of developing arrhythmia can be a more attractive option. The renin-angiotensin system (RAS) seems to be involved in the genesis of arrhythmia by the following two mechanisms: 1. the induction of atrial fibrosis and structural remodelling by mitogen-activated protein kinase (MAPK) expression and reduction of collagenase activity; 2. the induction of electrical re…
Recomendaciones del Club Español Pancreático para el diagnóstico y tratamiento de la pancreatitis crónica: parte 2 (tratamiento).
2013
Chronic pancreatitis (CP) is a complex disease with a wide spectrum of clinical manifestations ranging from asymptomatic disease to disabling forms or serious complications. The management of CP frequently differs among geographical areas and even among centers. These differences are due to the scarcity of high-quality studies and clinical practice guidelines that focus on the diagnosis and treatment of this disease. The aim of the Spanish Pancreatic Club was to create evidence-based recommendations for the management of CP. Two coordinators chose a multidisciplinary panel of 24 experts in this disease. These experts were selected on the basis of their clinical and research experience in CP…
Clinical evaluation and treatment of acute asthma exacerbations in children
2009
This update on treatment of asthma exacerbations in children is the result of an Italian Pediatric Society Task-force, made up of a panel of experts working in 2007–2008. The aim is to give clear indications on the use of the drugs most employed in children, grading the quality of evidence and the strength of recommendations. Suggestions on their limits due to unlicensed and off-label use are reported. The level of evidence and the strength of recommendations for different therapeutic approaches demonstrate that frequently the use of drugs in children is extrapolated from the experience in adults and that more studies are required to endorse the correct use of different drugs in asthmatic …
Hyaluronan for knee osteoarthritis: an updated meta-analysis of trials with low risk of bias
2015
International audience; Background The effectiveness of intra-articular hyaluronic acid (IAHA) injection for knee osteoarthritis (KOA) is debated.Objectives To evaluate the effect of IAHA for patients with KOA by analysing data from trials of IAHA versus placebo with low risk of bias, to provide the highest level of evidence.Methods A systematic review and meta-analysis was conducted. Randomised controlled trials (RCTs) with a low risk of bias (adequate randomisation and concealment and double-blind design) that investigated IAHA versus placebo (saline solution) injection were eligible. The primary efficacy measure was pain intensity and secondary outcome function at 3 months. The treatment…
Clinical Benefits of Early Triptan Therapy for Migraine
2004
The introduction of the triptans brought advances in achieving complete and sustained pain resolution in migraine patients, compared with non-migraine-specific treatments. However, sustained pain-free rates for triptans recorded in many clinical trials are still relatively low. This may be due to study participants being treated late into the attack, when pain is already moderate or severe. Studies with almotriptan have shown that efficacy is enhanced when treatment is given early in a migraine attack while pain is still mild, compared with later administration when pain intensity is greater. Developments in our understanding of migraine pathophysiology provide a rationale for this phenome…
Guidelines on enhanced recovery after pulmonary lobectomy
2021
International audience; Objective : To establish recommendations for optimisation of the management of patients undergoing pulmonary lobectomy, particularly Enhanced Recovery After Surgery (ERAS).Design : A consensus committee of 13 experts from the French Society of Anaesthesia and Intensive Care Medicine (Soci,t, franOaise d'anesth,sie et de r,animation, SFAR) and the French Society of Thoracic and Cardiovascular Surgery (Soci,t, franOaise de chirurgie thoracique et cardiovasculaire, SFCTCV) was convened. A formal conflict-of-interest policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independently of any industry funding.…