The usage of a simplified self-titration dosing guideline (303 Algorithm) for insulin detemir in patients with type 2 diabetes - results of the randomized, controlled PREDICTIVEtrade mark 303 study.

Diabetes Obes Metab. 2007 Nov;9(6):902-13

Authors: Meneghini L, Koenen C, Weng W, Selam JL

The Predictable Results and Experience in Diabetes through Intensification and Control to Target: An International Variability Evaluation 303 (PREDICTIVEtrade mark 303) Study (n = 5604) evaluated the effectiveness of insulin detemir, a long-acting basal insulin analogue, using a simplified patient self-adjusted dosing algorithm (303 Algorithm group) compared with standard-of-care physician-driven adjustments (Standard-of-care group) in a predominantly primary care setting, over a period of 6 months. Insulin detemir was to be started once-daily as add-on therapy to any other glucose-lowering regimens or as a replacement of prestudy basal insulin in patients with type 2 diabetes. Investigator sites rather than individual patients were randomized to either the 303 Algorithm group or the Standard-of-care group. Patients from the 303 Algorithm group sites were instructed to adjust their insulin detemir dose every 3 days based on the mean of three ‘adjusted’ fasting plasma glucose (aFPG) values (capillary blood glucose calibrated to equivalent plasma glucose values) using a simple algorithm: mean aFPG 110 mg/dl (>1.1 mmol/l), increase dose by 3 U. The insulin detemir dose for patients in the Standard-of-care group was adjusted by the investigator according to the standard of care. Mean A1C decreased from 8.5% at baseline to 7.9% at 26 weeks for the 303 Algorithm group and from 8.5 to 8.0% for the Standard-of-care group (p = 0.0106 for difference in A1C reduction between the two groups). Mean FPG values decreased from 175 mg/dl (9.7 mmol/l) at baseline to 141 mg/dl (7.8 mmol/l) for the 303 Algorithm group and decreased from 174 mg/dl (9.7 mmol/l) to 152 mg/dl (8.4 mmol/l) for the Standard-of-care group (p

PMID: 17924873 [PubMed - in process]

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Evidence Behind the WHO Guidelines: Hospital Care for Children: What are the Risks of HIV Transmission Through Breastfeeding?

J Trop Pediatr. 2007 Oct 9;

Authors: Bulteel N, Henderson P

PMID: 17925298 [PubMed - as supplied by publisher]

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A STRUCTURED APPROACH FOR THE ASSESSMENT OF INTERNAL DOSE: THE IDEAS GUIDELINES.

Radiat Prot Dosimetry. 2007 Oct 12;

Authors: Doerfel H, Andrasi A, Bailey M, Berkovski V, Blanchardon E, Castellani CM, Cruz-Suarez R, Hurtgen C, Leguen B, Malatova I, Marsh J, Stather J, Zeger J

The need for harmonisation of the procedures for internal dose assessment has been recognised within an EU research project under the 5th Framework Programme. The aim of the IDEAS project was to develop general guidelines for standardising assessments of intakes and internal doses. It started in October 2001 and ended in June 2005. The project is closely related to some goals of the work of Committee 2 of the International Commission on Radiological Protection and since 2003 there has been close co-operation between the two groups. The general philosophy of the guidelines is focusing on the principles of harmonisation, accuracy and proportionality. The proposed system of ‘level of task’ to structure the approach of internal dose evaluation is also reported. Some details of the internal structure of the guidelines for the different pathways of intake are provided.

PMID: 17933785 [PubMed - as supplied by publisher]

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147th ENMC International Workshop: Guideline on processing and evaluation of sural nerve biopsies, 15-17 December 2006, Naarden, The Netherlands.

Neuromuscul Disord. 2007 Oct 10;

Authors: Sommer C, Brandner S, Dyck PJ, Magy L, Mellgren SI, Morbin M, Schenone A, Tan E, Weis J

PMID: 17935990 [PubMed - as supplied by publisher]

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Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update: a guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group.

Circulation. 2007 Oct 16;116(16):e391-413

Authors: Broderick J, Connolly S, Feldmann E, Hanley D, Kase C, Krieger D, Mayberg M, Morgenstern L, Ogilvy CS, Vespa P, Zuccarello M, , ,

PURPOSE: The aim of this statement is to present current and comprehensive recommendations for the diagnosis and treatment of acute spontaneous intracerebral hemorrhage. METHODS: A formal literature search of Medline was performed through the end date of August 2006. The results of this search were complemented by additional articles on related issues known to the writing committee. Data were synthesized with the use of evidence tables. The American Heart Association Stroke Council’s Levels of Evidence grading algorithm was used to grade each recommendation. Prerelease review of the draft guideline was performed by 5 expert peer reviewers and by the members of the Stroke Council Leadership Committee. It is intended that this guideline be fully updated in 3 years’ time. RESULTS: Evidence-based guidelines are presented for the diagnosis of intracerebral hemorrhage, the management of increased arterial blood pressure and intracranial pressure, the treatment of medical complications of intracerebral hemorrhage, and the prevention of recurrent intracerebral hemorrhage. Recent trials of recombinant factor VII to slow initial bleeding are discussed. Recommendations for various surgical approaches for treatment of spontaneous intracerebral hemorrhage are presented. Finally, withdrawal-of-care and end-of-life issues in patients with intracerebral hemorrhage are examined.

PMID: 17938297 [PubMed - in process]

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Food-based dietary guidelines and implementation: lessons from four countries - Chile, Germany, New Zealand and South Africa.

Public Health Nutr. 2007 Oct 17;:1-8

Authors: Keller I, Lang T

OBJECTIVE: Food-based dietary guidelines (FBDGs) are globally promoted as an important part of national food and nutrition policies. They are presented within policy as key features of the strategy to educate the public and guide policy-makers and other stakeholders about a healthy diet. This paper examines the implementation of FBDGs in four countries: Chile, Germany, New Zealand and South Africa – diverse countries chosen to explore the realities of the FBDG within policy on public health nutrition. DESIGN: A literature review was carried out, followed by interviews with representatives from the governmental, academic and private sector in all four countries. RESULTS: In all four countries the FBDG is mainly implemented via written/electronic information provided to the public through the health and/or education sector. Data about the impact of FBDGs on policy and consumers’ food choice or dietary habits are incomplete; nutrition surveys do not enable assessment of how effective FBDGs are as a factor in dietary or behavioural change. Despite limitations, FBDGs are seen as being valuable by key stakeholders.ConclusionFBDGs are being implemented and there is experience which should be built upon. The policy focus needs to move beyond merely disseminating FBDGs. They should be part of a wider public health nutrition strategy involving multiple sectors and policy levels. Improvements in the implementation of FBDGs are crucial given the present epidemic of chronic, non-communicable diseases.

PMID: 17942004 [PubMed - as supplied by publisher]

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ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery.

J Am Coll Cardiol. 2007 Oct 23;50(17):e159-241

Authors: Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof E, Fleischmann KE, Freeman WK, Froehlich JB, Kasper EK, Kersten JR, Riegel B, Robb JF, Smith SC, Jacobs AK, Adams CD, Anderson JL, Antman EM, Buller CE, Creager MA, Ettinger SM, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Hunt SA, Lytle BW, Nishimura R, Ornato JP, Page RL, Riegel B, Tarkington LG, Yancy CW, , , , , , , , ,

PMID: 17950140 [PubMed - in process]

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ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery) Developed in Collaboration With the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery.

J Am Coll Cardiol. 2007 Oct 23;50(17):1707-1732

Authors: Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof E, Fleischmann KE, Freeman WK, Froehlich JB, Kasper EK, Kersten JR, Riegel B, Robb JF, Smith SC, Jacobs AK, Adams CD, Anderson JL, Antman EM, Buller CE, Creager MA, Ettinger SM, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Hunt SA, Lytle BW, Nishimura R, Ornato JP, Page RL, Riegel B, Tarkington LG, Yancy CW

PMID: 17950159 [PubMed - as supplied by publisher]

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Guidelines for hurricane and disaster preparation for animal facilities.

Lab Anim (NY). 2007 Nov;36(10):28-31

Authors: Thomas T

Animal facilities are vulnerable to hurricanes and other natural disasters, which can endanger lives and disrupt critical animal care routines. Facility managers must therefore prepare a rigorous emergency plan that ensures human safety while considering the specific needs of all animals on site. The author presents guidelines and recommendations for disaster preparedness based on her experience at a facility in Florida, where hurricanes are relatively common. An effective plan must include a priority system, a well-trained emergency response team, efficient communication methods and concrete provisions for animals and employees.

PMID: 17957177 [PubMed - in process]

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Treatment of unipolar psychotic depression: The use of evidence in practice guidelines.

World J Biol Psychiatry. 2007 Oct 24;:1-7

Authors: Wijkstra J, Schubart CD, Nolen WA

Introduction. In a recent meta-analysis we found no evidence that an antidepressant plus an antipsychotic is more effective than an antidepressant alone in unipolar psychotic depression. However, most current guidelines recommend the combination over an antidepressant alone. Method. We assessed available guidelines by the AGREE instrument and discuss their recommendations in relation to the evidence as referred to in the guidelines. Results. The UK-NICE guideline had the highest AGREE quality score, followed by the Dutch, Australian, and US-APA guidelines. Guidelines are not always consistent with at date of publication available evidence and (with exception of the UK-NICE and Dutch guidelines) also not with the in that guideline referred evidence. Conclusion. Physicians (and patients) should be aware that in guidelines treatment recommendations may be less evidence-based than asserted, even when treatment recommendations are stated as being based on the highest level of evidence.

PMID: 17963187 [PubMed - as supplied by publisher]

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