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Preoperative Verification of Timely Antimicrobial Prophylaxis Does Not Improve Compliance with Guidelines.

Surg Infect (Larchmt). 2010 Jul 27;

Authors: Nemeth TA, Beilman GJ, Hamlin CL, Chipman JG

Abstract Background: Surgical site infections are reduced by appropriate and timely antimicrobial prophylaxis. Consensus guidelines recommend that antimicrobial infusion begin within 60 min prior to creation of the incision. An internal audit of our institution suggested poor guideline compliance. We hypothesized that the addition of a oral antibiotic verification to the routine preoperative patient identification, operation, and surgical site verification would increase compliance. To this end, we compared compliance with the guidelines before and after the addition of a verification of antibiotic administration to the routine preoperative protocol. Methods: We performed a retrospective medical record review of operations during two five-day periods, one prior to and one after the addition of the antibiotic verification. We identified operative procedure, time of antibiotic administration, time of incision, and the patient's preoperative inpatient or outpatient status. We excluded from analysis patients whose procedure did not require antibiotic prophylaxis, inpatients, and patients without complete records. Administration of antimicrobial prophylaxis was considered timely (60 min prior to incision), late (beginning after incision), or not given (no antibiotic administered). Comparisons were made using the chi(2) statistic for noncontinuous variables with significance defined as p

PMID: 20662740 [PubMed - as supplied by publisher]

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Recommended Guidelines for the Conduct and Evaluation of Prognostic Studies in Veterinary Oncology.

Vet Pathol. 2010 Jul 27;

Authors: Webster JD, Dennis MM, Dervisis N, Heller J, Bacon NJ, Bergman PJ, Bienzle D, Cassali G, Castagnaro M, Cullen J, Esplin DG, Peña L, Goldschmidt MH, Hahn KA, Henry CJ, Hellmén E, Kamstock D, Kirpensteijn J, Kitchell BE, Amorim RL, Lenz SD, Lipscomb TP, McEntee M, McGill LD, McKnight CA, McManus PM, Moore AS, Moore PF, Moroff SD, Nakayama H, Northrup NC, Sarli G, Scase T, Sorenmo K, Schulman FY, Shoieb AM, Smedley RC, Spangler WL, Teske E, Thamm DH, Valli VE, Vernau W, von Euler H, Withrow SJ, Weisbrode SE, Yager J, Kiupel M

There is an increasing need for more accurate prognostic and predictive markers in veterinary oncology because of an increasing number of treatment options, the increased financial costs associated with treatment, and the emotional stress experienced by owners in association with the disease and its treatment. Numerous studies have evaluated potential prognostic and predictive markers for veterinary neoplastic diseases, but there are no established guidelines or standards for the conduct and reporting of prognostic studies in veterinary medicine. This lack of standardization has made the evaluation and comparison of studies difficult. Most important, translating these results to clinical applications is problematic. To address this issue, the American College of Veterinary Pathologists' Oncology Committee organized an initiative to establish guidelines for the conduct and reporting of prognostic studies in veterinary oncology. The goal of this initiative is to increase the quality and standardization of veterinary prognostic studies to facilitate independent evaluation, validation, comparison, and implementation of study results. This article represents a consensus statement on the conduct and reporting of prognostic studies in veterinary oncology from veterinary pathologists and oncologists from around the world. These guidelines should be considered a recommendation based on the current state of knowledge in the field, and they will need to be continually reevaluated and revised as veterinary oncology continues to progress. As mentioned, these guidelines were developed through an initiative of the American College of Veterinary Pathologists' Oncology Committee, and they have been reviewed and endorsed by the World Small Animal Veterinary Association.

PMID: 20664014 [PubMed - as supplied by publisher]

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Clinically Useful Spirometry in Preschool-Aged Children: Evaluation of the 2007 American Thoracic Society Guidelines.

J Asthma. 2010 Jul 26;

Authors: Gaffin JM, Shotola NL, Martin TR, Phipatanakul W

Rationale. In 2007 the American Thoracic Society (ATS) recommended guidelines for acceptability and repeatability for assessing spirometry in preschool children. The authors aim to determine the feasibility of spirometry among children in this age group performing spirometry for the first time in a busy clinical practice. Methods. First-time spirometry for children age 4 to 5 years old was selected from the Children's Hospital Boston Pulmonary Function Test (PFT) database. Maneuvers were deemed acceptable if ( 1 ) the flow-volume loop showed rapid rise and smooth descent; ( 2 ) the back extrapolated volume (V(be)), the volume leaked by a subject prior to the forced maneuver, was

PMID: 20653495 [PubMed - as supplied by publisher]

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Sins of omission and obfuscation: IQWIG's guidelines on economic evaluation methods.

Health Econ. 2010 Jul 26;

Authors: Sculpher M, Claxton K

PMID: 20662107 [PubMed - as supplied by publisher]

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[On the significance of guidelines for managing sedation at the end of life.]

Schmerz. 2010 Jul 25;

Authors: Neitzke G

PMID: 20658250 [PubMed - as supplied by publisher]

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Adherence to the dietary guidelines for Americans and endometrial cancer risk.

Cancer Causes Control. 2010 Jul 23;

Authors: Chandran U, Bandera EV, Williams-King MG, Sima C, Bayuga S, Pulick K, Wilcox H, Zauber AG, Olson SH

The Healthy Eating Index (HEI) was developed by the US Department of Agriculture with the goal of quantifying adherence to the Dietary Guidelines for Americans. The purpose of this study was to evaluate the impact of the HEI-2005 score and each of its components on endometrial cancer risk in a population-based case-control study in New Jersey. A total of 424 cases and 398 controls completed a Food Frequency Questionnaire, which was used to derive the HEI-2005 score. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression while adjusting for potential covariates, which included all major endometrial cancer risk factors. The adjusted OR for women in the highest quartile when compared to the lowest quartile was 0.83 (95% CI: 0.52-1.34). For the meat and beans component comprising meat, eggs, poultry, fish, and beans, the OR was 0.70 (95% CI: 0.45-1.11; p for trend: 0.07), with little evidence of an association with any of the individual foods. There was no indication of an association for any of the other components of the HEI or of effect modification by body mass index. This study suggested limited value for the HEI-2005 in predicting endometrial cancer risk.

PMID: 20652737 [PubMed - as supplied by publisher]

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AGREE II: Advancing guideline development, reporting and evaluation in health care.

J Clin Epidemiol. 2010 Jul 23;

Authors: Sibbald B, Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F, Feder G, Fervers B, Graham ID, Grimshaw J, Hanna SE, Littlejohns P, Makarski J, Zitzelsberger L,

PMID: 20656455 [PubMed - as supplied by publisher]

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The Relationship Between the Medical Director and the Executive Director: Guidelines for Success.

Psychiatr Q. 2010 Jul 17;

Authors: Gabel S

The positional leadership of mental health care organizations commonly is in the hands of an executive director who has had administrative experience, but who may or may not have had clinical experience. The medical director of the mental health organization is a psychiatrist who reports to the executive director despite their different backgrounds and areas of expertise. The relationship between these two leaders is the responsibility of both, and is crucial to the success of the organization. This paper is concerned specifically with approaches that can be taken by the medical director to foster a successful working alignment with the executive director. The situation has some similarities (and significant differences) with that described by Gabarro and Kotter in "Managing Your Boss" (1993). A series of guidelines to enhance the potential success of the medical director in this supervisor/supervisee relationship is presented.

PMID: 20640599 [PubMed - as supplied by publisher]

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Adherence to international guidelines for the treatment of invasive aspergillosis in acute myeloid leukaemia: feasibility and utility (SEIFEM-2008B study).

J Antimicrob Chemother. 2010 Jul 16;

Authors: Pagano L, Caira M, Offidani M, Martino B, Candoni A, Valentini CG, Specchia G, Nosari A, Tosti ME, Leone G, Luppi M, Aversa F

Objectives and methods In order to assess physicians' compliance with international guidelines for the targeted treatment of invasive aspergillosis, 136 patients with acute myeloid leukaemia and proven/probable invasive aspergillosis were analysed. Results Compliance with Infectious Diseases Society of America (IDSA) and European Conference on Infections in Leukaemia (ECIL) guidelines was found to be relatively low (28% for ECIL and 55% for IDSA), although no significant differences were found between the two groups (adherence versus non-adherence). In both subgroup analyses (IDSA and ECIL), compliance with the guidelines did not impact the 120 day survival rate. Instead, adherence to guidelines led to a higher response rate to first-line antifungal treatment (76% in the IDSA group and 84% in the ECIL group). Conclusions Guidelines establish categories of patients with homogeneous characteristics, and suggest optimal diagnostic and therapeutic options for them. Acquisition of good results through adherence to guidelines is confirmed by our series. Unfortunately, there are frequently reasons to deviate from these general recommendations, particularly in patients with acute myeloid leukaemia. Despite evidence-based recommendations, adherence to the guidelines does not constitute the best therapeutic choice in each and every patient. Subjects' clinical conditions and co-morbidities vary widely, and sometimes render the 'recommended' drug a non-applicable strategy.

PMID: 20639313 [PubMed - as supplied by publisher]

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[CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials (Chinese version).]

Zhong Xi Yi Jie He Xue Bao. 2010 Jul 15;8(7):604-612

Authors: Schulz KF, Altman DG, Moher D, Consort Group

Abstract: The CONSORT statement is used worldwide to improve the reporting of randomised controlled trials. Kenneth Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience. To encourage dissemination of the CONSORT 2010 Statement, this article is freely accessible on bmj.com and will also be published in the Lancet, Obstetrics and Gynecology, PLoS Medicine, Annals of Internal Medicine, Open Medicine, Journal of Clinical Epidemiology, BMC Medicine, and Trials.

PMID: 20619135 [PubMed - as supplied by publisher]

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