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EMQN Best Practice Guidelines for molecular genetic testing of SCAs.

Eur J Hum Genet. 2010 Feb 24;

Authors: Sequeiros J, Martindale J, Seneca S

Other participants at the EMQN Best Practice Meeting and/or at the electronic discussions thereafter were Isabel Alonso, Anna Andersson, David Barton, Nazli Bazac, Kyproula Christodoulou, Luís Correia, Mark Davis, Mary Davis, Rob Elles, Marina Frontali, Javier Garcia-Planells, Paola Giunti, Petra Hämäläinen, Jenni Jonasson, Outi Kamarainen, Nina Larsson, Eric Leguern, Monique Losekoot, Carla Martins, Michael Morris, Clemens Müller-Reible, Simon Patton, M Luiza Saraiva-Pereira, Jorge Pinto-Basto, Beatriz Quintáns, Simon C Ramsden, Anna Ravani, Laura Rooke, Isabel Silveira, Richard Sinke, Su Stenhouse, Laura Stewart, Katrien Storm, Anna Sulek-Piatkowska, Francine Thonney, Victor Volpini, Jon Warner, Helga Weirich, Stefan Wieczorek and Christine Zühlke.European Journal of Human Genetics advance online publication, 24 February 2010; doi:10.1038/ejhg.2010.8.

PMID: 20179742 [PubMed - as supplied by publisher]

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Guidelines for the organization of headache education in Europe: the headache school II.

J Headache Pain. 2010 Feb 24;

Authors: Jensen R, Mitsikostas DD, Valade D, Antonaci F

In order to promote education on headache disorders, European Headache Federation (EHF) in conjunction with National Headache Societies organizes educational courses meeting uniform standards according to previous published guidelines. Based on six headache summer schools' experience, an EHF subcommittee has reviewed these guidelines, and here the revised version is presented. The goals remain the same: quality courses that will attract physicians and neurologists seeking to increase their knowledge, skills, and understanding in the area of primary and secondary headache. Detailed guidelines, a day-to-day program, and a multiple-choice test battery have now been outlined. It is recommended to include practical sessions with patient interviews and hands-on demonstrations of non-pharmacological treatment strategies. For countries that want a 'low cost' education program, a Video School program of a similar scientific standard has been developed. To be certified for CME credits, patronage, and financial support from EHF, it is highly recommended to adhere to the suggested teaching strategies. We hereby aim to promote and professionalize the education in headache disorders and endorse the educational courses meeting uniform standards of excellence.

PMID: 20179986 [PubMed - as supplied by publisher]

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Atrial fibrillation in Africa: clinical characteristics, prognosis, and adherence to guidelines in Cameroon.

Europace. 2010 Feb 23;

Authors: Ntep-Gweth M, Zimmermann M, Meiltz A, Kingue S, Ndobo P, Urban P, Bloch A

Aims The purpose of this prospective study was to characterize the clinical profile of patients with atrial fibrillation (AF) in the urban population of a sub-Saharan African country and to assess how successfully current guidelines are applied in that context. Methods and results This prospective study involved 10 cardiologists in Cameroon. Enrolment started on 1 June 2006 and ended on 30 June 2007. Consecutive patients were included if they were >18 years and AF was documented on an ECG during the index office visit. In this survey, 172 patients were enrolled (75 males and 97 females; mean age 65.8 +/- 13 years). The prevalence of paroxysmal, persistent, and permanent AF was 22.7, 21.5, and 55.8%, respectively. Underlying cardiac disorders, present in 156/172 patients (90.7%), included hypertensive heart disease (47.7%), valvular heart disease (25.6%), dilated cardiomyopathy (15.7%), and coronary artery disease (6%). A rate-control strategy was chosen in 83.7% of patients (144 of 172) and drugs most commonly used were digoxin and amiodarone. The mean CHADS(2) score was 1.9 +/- 1.1 and 158 of 172 patients (91.9%) had a CHADS(2) score >/=1. Among patients with an indication for oral anticoagulation (OAC), only 34.2% (54 of 158) actually received it. During a follow-up of 318 +/- 124 days, 26 of 88 patients died (29.5%), essentially from a cardiovascular cause (15 of 26). Ten patients (16.1%) had a non-lethal embolic stroke and 23 (26.1%) had symptoms of severe congestive heart failure. Conclusion Clinical presentation of AF in Cameroon is much more severe than in developed countries. A rate-control strategy is predominant in Cameroon and OAC is prescribed in only 34.2% of eligible patients, despite a high CHADS(2) score at inclusion. Death and stroke rate at 1 year are very high in Cameroon possibly because of a lower use of OAC, and a higher prevalence of rheumatic mitral disease and of more severe co-morbidities.

PMID: 20179174 [PubMed - as supplied by publisher]

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Pre-Hospital Care Management Of A Potential Spinal Cord Injured Patient: A Systematic Review of the Literature and Evidence Based Guidelines.

J Neurotrauma. 2010 Feb 22;

Authors: Ahn H, Singh J, Nathens A, Macdonald R, Travers A, Tallon JM, Fehlings M, Yee A

An interdisciplinary expert panel of medical and surgical specialists involved in the management of patients with potential spinal cord injuries was assembled. Three key questions focused on the pre-hospital management of patients with acute spinal cord injury were generated. These were: 1) What is the optimal type and duration of pre-hospital spinal immobilization in patients with acute SCI? 2) During airway manipulation in the pre-hospital setting, what is the ideal method of spinal immobilization? 3) What is the impact of pre-hospital transport times to definitive care on the outcomes of patients with acute spinal cord injury? A systematic review utilizing multiple databases was performed to determine the current evidence for the specific questions and each article was reviewed and assessed by two reviewers independently based on inclusion and exclusion criteria. Guidelines were then created relating to the questions asked. A national Canadian expert panel applied Delphi methods to review and refine recommendations based on the best available evidence for each question (30;36;37).

PMID: 20175667 [PubMed - as supplied by publisher]

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[Perioperative cardiac care for non-cardiac surgery : 2009 Guidelines of the European Society of Cardiology.]

Anaesthesist. 2010 Feb 17;

Authors: Priebe HJ

Since November 2009, the first European guidelines on perioperative cardiac care for non-cardiac surgery have been published by the European Society of Cardiology (ESC) and endorsed by the European Society of Anaesthesiology (ESA). The following article will describe the most important recommendations of these guidelines and discuss the clinically relevant differences to the corresponding recommendations of the current guidelines of the American College of Cardiology (ACC) and the American Heart Association (AHA).

PMID: 20157686 [PubMed - as supplied by publisher]

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Flawed Experimental Design Reveals the Need for Guidelines Requiring Appropriate Positive Controls in Endocrine Disruption Research.

Toxicol Sci. 2010 Feb 17;

Authors: Vom Saal FS

PMID: 20164146 [PubMed - as supplied by publisher]

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[Adherence to antibiotherapy guidelines for acute community-acquired pneumonia in adults, in a teaching hospital.]

Med Mal Infect. 2010 Feb 17;

Authors: Martinez JS, Le Falher G, Corne P, Bourdin A, Lequellec A, Delabre JP, Makinson A, Hansel S, Reynes J, Le Moing V

OBJECTIVE: The authors had for aim to assess the conformity of antibiotic prescription with guidelines, for the management of community-acquired pneumonia, in a French University Hospital. DESIGN: This prospective study included adults patients hospitalized for pneumonia over a period of six months. The attending physician estimated the severity of pneumonia. The adequacy to guidelines focused on: first antibiotic choice and prescription modality, antibiotic choice in case of treatment modification at 48 to72hours, and duration of antibiotherapy. RESULTS: A hundred and nine cases of pneumonia were included in 106 patients. The mean age was 66 years, the mortality rate was 17 %. Bacterial documentation was recorded in 40.4 % of cases. The first antibiotics used were in accordance with guidelines in 52.3 % of cases. The non conformity rate was minor in 55.8 % of cases. Antibiotherapies putting the patient at risk were used in less than 10 % of the cases. The rate of antibiotic modification at 48 to 72hours was 46.8 %, primarily for bacteriological purposes (35.3 %) or initial treatment failure (27.4 %). The treatment duration was inappropriate in 52.7 % of cases and generally too long in case of non conformity. CONCLUSION: It seems important to support guideline information, training of prescribers, and to consult an antibiotic expert.

PMID: 20171030 [PubMed - as supplied by publisher]

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[An evidence based Iberic-Latin American guideline for acute gastroenteritis management in infants and prescholars.]

An Pediatr (Barc). 2010 Feb 17;

Authors: Gutiérrez Castrellón P, Polanco Allué I, Salazar Lindo E

Acute gastroenteritis (AG) morbidity and mortality rates in infants and prescholars continue to be high in developing countries. Authors want to develop an evidence-based document that supports decision making regarding AG therapy in infants and children younger than 5 y/o. A systematic review of the literature was performed (May, 2008). Evidence grading was established according to Oxford guidelines and Latin American experts submitted their opinions on the recommendations generated. Oral rehydration solutions are the threatment’s keystone for children with AG, showing lesser complications due to therapy than IV fluids. AG is no contraindication of a normal diet. Racecadotril, zinc and smectite can contribute to AG treatment, as well as Lactobacillus GG and Saccharomycces boulardii. No other drugs are recommended. It is recommended to treat children presenting AG with oral rehydration solutions among racecadotril, zinc or smectite as well as some probiotics.

PMID: 20171152 [PubMed - as supplied by publisher]

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Evaluation of the American Heart Association Cardiovascular Disease Prevention Guideline for Women.

Circ Cardiovasc Qual Outcomes. 2010 Feb 16;

Authors: Hsia J, Rodabough RJ, Manson JE, Liu S, Freiberg MS, Graettinger W, Rosal MC, Cochrane B, Lloyd-Jones D, Robinson JG, Howard BV,

Background The 2007 update to the American Heart Association (AHA) guidelines for cardiovascular disease prevention in women recommend a simplified approach to risk stratification. We assigned Women's Health Initiative participants to risk categories as described in the guideline and evaluated clinical event rates within and between strata. Methods and Results The Women's Health Initiative enrolled 161 808 women ages 50 to 79 years and followed them prospectively for 7.8 years (mean). Applying the 2007 AHA guideline categories, 11% of women were high risk, 72% at-risk, and 4% at optimal risk; 13% of women did not fall into any category, that is, lacked risk factors but did not adhere to a healthy lifestyle (moderate intensity exercise for 30 minute most days and <7% of calories from saturated fat). Among high risk, at-risk, and optimal risk women, rates of myocardial infarction/coronary death were 12.5%, 3.1%, and 1.1% per 10 years (P for trend <0.0001); the event rate was 1.3% among women who could not be categorized. We observed a graded relationship between risk category and cardiovascular event rates for white, black, Hispanic, and Asian women, although event rates differed among ethnic groups (P for interaction=0.002). The AHA guideline predicted coronary events with accuracy similar to current Framingham risk categories (area under receiver operating characteristic curve for Framingham risk, 0.665; for AHA risk, 0.664; P=0.94) but less well than proposed Framingham 10-year risk categories of <5%, 5% to 20%, and >20% (area under receiver operating characteristic curve for Framingham risk, 0.724; for AHA risk, 0.664; P<0.0001). Conclusions Risk stratification as proposed in the 2007 AHA guideline is simple, accessible to patients and providers, and identifies cardiovascular risk with accuracy similar to that of the current Framingham algorithm.

PMID: 20160160 [PubMed - as supplied by publisher]

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The Gap Between Evidence-Based Guidelines and Daily Practice.

World J Surg. 2010 Feb 12;

Authors: Slim K

PMID: 20151123 [PubMed - as supplied by publisher]

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