Browsing by Subject "Guidelines"

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  • Coccolini, Federico; Stahel, Philip F.; Montori, Giulia; Biffl, Walter; Horer, Tal M.; Catena, Fausto; Kluger, Yoram; Moore, Ernest E.; Peitzman, Andrew B.; Ivatury, Rao; Coimbra, Raul; Fraga, Gustavo Pereira; Pereira, Bruno; Rizoli, Sandro; Kirkpatrick, Andrew; Leppäniemi, Ari; Manfredi, Roberto; Magnone, Stefano; Chiara, Osvaldo; Solaini, Leonardo; Ceresoli, Marco; Allievi, Niccolo; Arvieux, Catherine; Velmahos, George; Balogh, Zsolt; Naidoo, Noel; Weber, Dieter; Abu-Zidan, Fikri; Sartelli, Massimo; Ansaloni, Luca (2017)
    Complex pelvic injuries are among the most dangerous and deadly trauma related lesions. Different classification systems exist, some are based on the mechanism of injury, some on anatomic patterns and some are focusing on the resulting instability requiring operative fixation. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic impairment of pelvic ring function and the associated injuries. The management of pelvic trauma patients aims definitively to restore the homeostasis and the normal physiopathology associated to the mechanical stability of the pelvic ring. Thus the management of pelvic trauma must be multidisciplinary and should be ultimately based on the physiology of the patient and the anatomy of the injury. This paper presents the World Society of Emergency Surgery (WSES) classification of pelvic trauma and the management Guidelines.
  • Tarasconi, Antonio; Coccolini, Federico; Biffl, Walter L.; Tomasoni, Matteo; Ansaloni, Luca; Picetti, Edoardo; Molfino, Sarah; Shelat, Vishal; Cimbanassi, Stefania; Weber, Dieter G.; Abu-Zidan, Fikri M.; Campanile, Fabio C.; Di Saverio, Salomone; Baiocchi, Gian Luca; Casella, Claudio; Kelly, Michael D.; Kirkpatrick, Andrew W.; Leppäniemi, Ari; Moore, Ernest E.; Peitzman, Andrew; Fraga, Gustavo Pereira; Ceresoli, Marco; Maier, Ronald V.; Wani, Imtaz; Pattonieri, Vittoria; Perrone, Gennaro; Velmahos, George; Sugrue, Michael; Sartelli, Massimo; Kluger, Yoram; Catena, Fausto (2020)
    Background Peptic ulcer disease is common with a lifetime prevalence in the general population of 5-10% and an incidence of 0.1-0.3% per year. Despite a sharp reduction in incidence and rates of hospital admission and mortality over the past 30 years, complications are still encountered in 10-20% of these patients. Peptic ulcer disease remains a significant healthcare problem, which can consume considerable financial resources. Management may involve various subspecialties including surgeons, gastroenterologists, and radiologists. Successful management of patients with complicated peptic ulcer (CPU) involves prompt recognition, resuscitation when required, appropriate antibiotic therapy, and timely surgical/radiological treatment. Methods The present guidelines have been developed according to the GRADE methodology. To create these guidelines, a panel of experts was designed and charged by the board of the WSES to perform a systematic review of the available literature and to provide evidence-based statements with immediate practical application. All the statements were presented and discussed during the 5th WSES Congress, and for each statement, a consensus among the WSES panel of experts was reached. Conclusions The population considered in these guidelines is adult patients with suspected complicated peptic ulcer disease. These guidelines present evidence-based international consensus statements on the management of complicated peptic ulcer from a collaboration of a panel of experts and are intended to improve the knowledge and the awareness of physicians around the world on this specific topic. We divided our work into the two main topics, bleeding and perforated peptic ulcer, and structured it into six main topics that cover the entire management process of patients with complicated peptic ulcer, from diagnosis at ED arrival to post-discharge antimicrobial therapy, to provide an up-to-date, easy-to-use tool that can help physicians and surgeons during the decision-making process.
  • Vander Poorten, Vincent; Uyttebroek, Saartje; Robbins, K. Thomas; Rodrigo, Juan P.; de Bree, Remco; Laenen, Annouschka; Saba, Nabil F.; Suarez, Carlos; Mäkitie, Antti; Rinaldo, Alessandra; Ferlito, Alfio (2020)
    BackgroundThe optimal evidence-based prophylactic antibiotic regimen for surgical site infections following major head and neck surgery remains a matter of debate.MethodsMedline, Cochrane, and Embase were searched for the current best evidence. Retrieved manuscripts were screened according to the PRISMA guidelines. Included studies dealt with patients over 18 years of age that underwent clean-contaminated head and neck surgery (P) and compared the effect of an intervention, perioperative administration of different antibiotic regimens for a variable duration (I), with control groups receiving placebo, another antibiotic regimen, or the same antibiotic for a different postoperative duration (C), on surgical site infection rate as primary outcome (O) (PICO model). A systematic review was performed, and a selected group of trials investigating a similar research question was subjected to a random-effects model meta-analysis.ResultsThirty-nine studies were included in the systematic review. Compared with placebo, cefazolin, ampicillin-sulbactam, and amoxicillin-clavulanate were the most efficient agents. Benzylpenicillin and clindamycin were clearly less effective. Fifteen studies compared short- to long-term prophylaxis; treatment for more than 48 h did not further reduce wound infections. Meta-analysis of five clinical trials including 4336 patients, where clindamycin was compared with ampicillin-sulbactam, implied an increased infection rate for clindamycin-treated patients (OR=2.73, 95% CI 1.50-4.97, p=0.001).ConclusionIn clean-contaminated head and neck surgery, cefazolin, amoxicillin-clavulanate, and ampicillin-sulbactam for 24-48 h after surgery were associated with the highest prevention rate of surgical site infection.
  • VICCCS Grp; Jokinen, Hanna (2018)
    Introduction: Progress in understanding and management of vascular cognitive impairment (VCI) has been hampered by lack of consensus on diagnosis, reflecting the use of multiple different assessment protocols. A large multinational group of clinicians and researchers participated in a two-phase Vascular Impairment of Cognition Classification Consensus Study (VICCCS) to agree on principles (VICCCS-1) and protocols (VICCCS-2) for diagnosis of VCI. We present VICCCS-2. Methods: We used VICCCS-1 principles and published diagnostic guidelines as points of reference for an online Delphi survey aimed at achieving consensus on clinical diagnosis of VCI. Results: Six survey rounds comprising 65-79 participants agreed guidelines for diagnosis of VICCCS-revised mild and major forms of VCI and endorsed the National Institute of Neurological Disorders-Canadian Stroke Network neuropsychological assessment protocols and recommendations for imaging. Discussion: The VICCCS-2 suggests standardized use of the National Institute of Neurological Disorders-Canadian Stroke Network recommendations on neuropsychological and imaging assessment for diagnosis of VCI so as to promote research collaboration. (C) 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.
  • Coccolini, Federico; Montori, Giulia; Catena, Fausto; Kluger, Yoram; Biffl, Walter; Moore, Ernest E.; Reva, Viktor; Bing, Camilla; Bala, Miklosh; Fugazzola, Paola; Bahouth, Hany; Marzi, Ingo; Velmahos, George; Ivatury, Rao; Soreide, Kjetil; Horer, Tal; ten Broek, Richard; Pereira, Bruno M.; Fraga, Gustavo P.; Inaba, Kenji; Kashuk, Joseph; Parry, Neil; Masiakos, Peter T.; Mylonas, Konstantinos S.; Kirkpatrick, Andrew; Abu-Zidan, Fikri; Gomes, Carlos Augusto; Benatti, Simone Vasilij; Naidoo, Noel; Salvetti, Francesco; Maccatrozzo, Stefano; Agnoletti, Vanni; Gamberini, Emiliano; Solaini, Leonardo; Costanzo, Antonio; Celotti, Andrea; Tomasoni, Matteo; Khokha, Vladimir; Arvieux, Catherine; Napolitano, Lena; Handolin, Lauri; Pisano, Michele; Magnone, Stefano; Spain, David A.; de Moya, Marc; Davis, Kimberly A.; De Angelis, Nicola; Leppaniemi, Ari; Ferrada, Paula; Latifi, Rifat; Navarro, David Costa; Otomo, Yashuiro; Coimbra, Raul; Maier, Ronald V.; Moore, Frederick; Rizoli, Sandro; Sakakushev, Boris; Galante, Joseph M.; Chiara, Osvaldo; Cimbanassi, Stefania; Mefire, Alain Chichom; Weber, Dieter; Ceresoli, Marco; Peitzman, Andrew B.; Wehlie, Liban; Sartelli, Massimo; Di Saverio, Salomone; Ansaloni, Luca (2017)
    Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions. Lastly, as the management of adults and children must be different, children should always be treated in dedicated pediatric trauma centers. In fact, the vast majority of pediatric patients with blunt splenic trauma can be managed non-operatively. This paper presents the World Society of Emergency Surgery (WSES) classification of splenic trauma and the management guidelines.
  • Granlund, Peder Annaeus; Odegaard, Jostein Strand; Skjerven, Havard Ove; Carlsen, Karin C. Lodrup; Hanseus, Katarina; Rognvaldsson, Ingolfur; Sunnegardh, Jan; Turanlahti, Maila L.; Holmstrom, Henrik (2019)
    Aim This study determined the use of standardised procedures for infant noninvasive blood pressure (NIBP) measurements in the Nordic countries and aimed to identify factors included in the standardisation and interpretation of NIBP measurements in infants. Methods A cross-sectional electronic questionnaire survey was sent to 84 physicians in all 23 university hospitals in Sweden, Norway, Denmark, Finland and Iceland and was completed from February to March 2017. The survey contained respondent characteristics, the presence and description of standardised procedures for NIBP measurements, daily practice of NIBP measurements and methodological considerations and interpretation of NIBP measurements in a healthy six-month-old child. Results We received responses from 55 of 84 physicians working in all 23 Nordic university hospitals, in paediatric cardiology (n = 22), general paediatrics (n = 16), paediatric nephrology (n = 14) and other fields (n = 3). Less than a quarter (23%) said their hospital issued specific NIBP procedures relating to infants and they referred to 19 different sources of information. The factors that were most commonly assessed for interpretation were age (100%), arousal state (78%) and cuff size (76%). Conclusion Most of the university hospital units treating children lacked age-specific written procedures for measuring and interpreting infant NIBP, and there is a strong need for common Nordic guidelines.
  • Titus, Brian K.; Brown, Kevin; Helmisaari, Heljä-Sisko; Vanguelova, Elena; Stupak, Inge; Evans, Alexander; Clarke, Nicholas; Guidi, Claudia; Bruckman, Viktor J.; Varnagiryte-Kabasinskiene, Iveta; Armolaitis, Kęstutis; de Vries, Wim; Hirai, Keizo; Kaarakka, Lilli; Hogg, Karen; Reece, Pam (2021)
    Forest biomass harvesting guidelines help ensure the ecological sustainability of forest residue harvesting for bioenergy and bioproducts, and hence contribute to social license for a growing bioeconomy. Guidelines, typically voluntary, provide a means to achieve outcomes often required by legislation, and must address needs related to local or regional context, jurisdictional compatibility with regulations, issues of temporal and spatial scale, and incorporation of appropriate scientific information. Given this complexity, comprehensive reviews of existing guidelines can aid in development of new guidelines or revision of existing ones. We reviewed 32 guidelines covering 43 jurisdictions in the USA, Canada, Europe and East Asia to expand upon information evaluated and recommendations provided in previous guideline reviews, and compiled a searchable spreadsheet of direct quotations from documents as a foundation for our review. Guidelines were considered in the context of sustainable forest management (SFM), focusing on guideline scope and objectives, environmental sustainability concerns (soils, site productivity, biodiversity, water and carbon) and social concerns (visual aesthetics, recreation, and preservation of cultural, historical and archaeological sites). We discuss the role of guidelines within the context of other governance mechanisms such as SFM policies, trade regulations and non-state market-driven (NSMD) standards, including certification systems. The review provides a comprehensive resource for those developing guidelines, or defining sustainability standards for market access or compliance with public regulations, and/or concerned about the sustainability of forest biomass harvesting. We recommend that those developing or updating guidelines consider (i) the importance of well-defined and understood terminology, consistent where possible with guidelines in other jurisdictions or regions; (ii) guidance based on locally relevant research, and periodically updated to incorporate current knowledge and operational experience; (iii) use of indicators of sensitive soils, sites, and stands which are relevant to ecological processes and can be applied operationally; and (iv) incorporation of climate impacts, long-term soil carbon storage, and general carbon balance considerations when defining sustainable forest biomass availability. Successful implementation of guidelines depends both on the relevance of the information and on the process used to develop and communicate it; hence, appropriate stakeholders should be involved early in guideline development.
  • Yan, Wen; Chen, Qian; Zhang, Xuemei; Elovainio, Marko; Huang, Yan (BioMed Central, 2019)
    Abstract Background The use of guidelines has shown to improve clinical practice process and structure of health care, but health care providers don’t always use and keep up-to-date with the new clinical practice guidelines. Nurses’ attitudes towards guidelines have shown to be the most frequently identified factor affecting their actual use of clinical practice guidelines, but no instruments for measuring it are available in China. There are scales validated in the western countries, but there is no information about their validity in Chinese health care. The purpose of this study is to test the validity and reliability of Chinese Attitudes towards guidelines - scale for nurses. Methods The study was conducted from April to July 2017. The Attitudes towards guidelines scale was translated into Chinese with forward-backward translation method and a questionnaire survey was conducted. Eight hundred randomly selected nurses (final N = 768) from Geriatrics, Internal medical and Rehabilitation departments of 16 hospitals were drawn in Sichuan province, China. Construct validity was evaluated by exploratory and confirmatory factor analysis, and reliability was assessed by test-retest reliability (represented by intra class correlation) and internal consistency (expressed by Cronbach’s coefficients). The test-retest reliability was examined with a sample of 32 clinical nurses who filled out the questionnaire 14 days after the first survey. Results Exploratory factor analysis supported a four-factor model for the Chinese version of the scale. Confirmatory factor analysis indicated that the hypothetical four-factor model fitted the data relatively well. The intra class correlation coefficient was 0.85 (95%CI, 0.68–0.93) and the Cronbach’s alpha values for the four subscales ranged from 0.645 to 0.912. Conclusions The results support the acceptable level of validity and reliability of the Chinese version of Attitudes towards guidelines scale, which can be used to assess nurses’ attitudes towards guidelines in China. Future testing for the Chinese version of Attitudes towards guidelines scale needs to be carried out to see whether these results are generalizable to other professionals and occupational groups and to be used to revise attitudes towards specific guidelines in China.
  • Coccolini, Federico; Roberts, Derek; Ansaloni, Luca; Ivatury, Rao; Gamberini, Emiliano; Kluger, Yoram; Moore, Ernest E.; Coimbra, Raul; Kirkpatrick, Andrew W.; Pereira, Bruno M.; Montori, Giulia; Ceresoli, Marco; Abu-Zidan, Fikri M.; Sartelli, Massimo; Velmahos, George; Fraga, Gustavo Pereira; Leppaniemi, Ari; Tolonen, Matti; Galante, Joseph; Razek, Tarek; Maier, Ron; Bala, Miklosh; Sakakushev, Boris; Khokha, Vladimir; Malbrain, Manu; Agnoletti, Vanni; Peitzman, Andrew; Demetrashvili, Zaza; Sugrue, Michael; Saverio, Salomone Di; Martzi, Ingo; Soreide, Kjetil; Biffl, Walter; Ferrada, Paula; Parry, Neil; Montravers, Philippe; Melotti, Rita Maria; Salvetti, Francesco; Valetti, Tino M.; Scalea, Thomas; Chiara, Osvaldo; Cimbanassi, Stefania; Kashuk, Jeffry L.; Larrea, Martha; Hernandez, Juan Alberto Martinez; Lin, Heng-Fu; Chirica, Mircea; Arvieux, Catherine; Bing, Camilla; Horer, Tal; Simone, Belinda De; Masiakos, Peter; Reva, Viktor; DeAngelis, Nicola; Kike, Kaoru; Balogh, Zsolt J.; Fugazzola, Paola; Tomasoni, Matteo; Latifi, Rifat; Naidoo, Noel; Weber, Dieter; Handolin, Lauri; Inaba, Kenji; Hecker, Andreas; Kuo-Ching, Yuan; Ordoñez, Carlos A.; Rizoli, Sandro; Gomes, Carlos Augusto; Moya, Marc De; Wani, Imtiaz; Mefire, Alain Chichom; Boffard, Ken; Napolitano, Lena; Catena, Fausto (2018)
    Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a "planned second-look" laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption. The open abdomen in trauma and non-trauma patients has been proposed to be effective in preventing or treating deranged physiology in patients with severe injuries or critical illness when no other perceived options exist. Its use, however, remains controversial as it is resource consuming and represents a non-anatomic situation with the potential for severe adverse effects. Its use, therefore, should only be considered in patients who would most benefit from it. Abdominal fascia-to-fascia closure should be done as soon as the patient can physiologically tolerate it. All precautions to minimize complications should be implemented.
  • Skrobot, Olivia A.; O'Brien, John; Black, Sandra; Chen, Christopher; DeCarli, Charles; Erkinjuntti, Timo; Ford, Gary A.; Kalaria, Rajesh N.; Pantoni, Leonardo; Pasquier, Florence; Roman, Gustavo C.; Wallin, Anders; Sachdev, Perminder; Skoog, Ingmar; Ben-Shlomo, Yoav; Passmore, Anthony P.; Love, Seth; Kehoe, Patrick G.; VICCCS Grp; Jokinen, H. (2017)
    Introduction: Numerous diagnostic criteria have tried to tackle the variability in clinical manifestations and problematic diagnosis of vascular cognitive impairment (VCI) but none have been universally accepted. These criteria have not been readily comparable, impacting on clinical diagnosis rates and in turn prevalence estimates, research, and treatment. Methods: The Vascular Impairment of Cognition Classification Consensus Study (VICCCS) involved participants (81% academic researchers) from 27 countries in an online Delphi consensus study. Participants reviewed previously proposed concepts to develop new guidelines. Results: VICCCS had a mean of 122 (98-153) respondents across the study and a 67% threshold to represent consensus. VICCCS redefined VCI including classification of mild and major forms of VCI and subtypes. It proposes new standardized VCI-associated terminology and future research priorities to address gaps in current knowledge. Discussion: VICCCS proposes a consensus-based updated conceptualization of VCI intended to facilitate standardization in research. (C) 2016 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.
  • Valiulis, A.; Bousquet, J.; Veryga, A.; Suprun, U.; Sergeenko, D.; Cebotari, S.; Borelli, D.; Pietikainen, S.; Banys, J.; Agache, I.; Billo, N. E.; Bush, A.; Chkhaidze, I.; Dubey, L.; Fokkens, W. J.; Grigg, J.; Haahtela, T.; Julge, K.; Katilov, O.; Khaltaev, N.; Odemyr, M.; Palkonen, S.; Savli, R.; Utkus, A.; Vilc, V.; Alasevicius, T.; Bedbrook, A.; Bewick, M.; Chorostowska-Wynimko, J.; Danila, E.; Hadjipanayis, A.; Karseladze, R.; Kvedariene, V.; Lesinskas, E.; Munter, L.; Samolinski, B.; Sargsyan, S.; Sitkauskiene, B.; Somekh, D.; Vaideliene, L.; Valiulis, A.; Hellings, P. W. (2019)
    Background: Over 1 billion people suffer from chronic respiratory diseases such as asthma, COPD, rhinitis and rhinosinusitis. They cause an enormous burden and are considered as major non-communicable diseases. Many patients are still uncontrolled and the cost of inaction is unacceptable. A meeting was held in Vilnius, Lithuania (March 23, 2018) under the patronage of the Ministry of Health and several scientific societies to propose multisectoral care pathways embedding guided self-management, mHealth and air pollution in selected chronic respiratory diseases (rhinitis, chronic rhinosinusitis, asthma and COPD). The meeting resulted in the Vilnius Declaration that was developed by the participants of the EU Summit on chronic respiratory diseases under the leadership of Euforea. Conclusion: The Vilnius Declaration represents an important step for the fight against air pollution in chronic respiratory diseases globally and has a clear strategic relevance with regard to the EU Health Strategy as it will bring added value to the existing public health knowledge.
  • Di Saverio, Salomone; Birindelli, Arianna; Kelly, Micheal D.; Catena, Fausto; Weber, Dieter G.; Sartelli, Massimo; Sugrue, Michael; De Moya, Mark; Gomes, Carlos Augusto; Bhangu, Aneel; Agresta, Ferdinando; Moore, Ernest E.; Soreide, Kjetil; Griffiths, Ewen; De Castro, Steve; Kashuk, Jeffry; Kluger, Yoram; Leppaniemi, Ari; Ansaloni, Luca; Andersson, Manne; Coccolini, Federico; Coimbra, Raul; Gurusamy, Kurinchi S.; Campanile, Fabio Cesare; Biffl, Walter; Chiara, Osvaldo; Moore, Fred; Peitzman, Andrew B.; Fraga, Gustavo P.; Costa, David; Maier, Ronald V.; Rizoli, Sandro; Balogh, Zsolt J.; Bendinelli, Cino; Cirocchi, Roberto; Tonini, Valeria; Piccinini, Alice; Tugnoli, Gregorio; Jovine, Elio; Persiani, Roberto; Biondi, Antonio; Scalea, Thomas; Stahel, Philip; Ivatury, Rao; Velmahos, George; Andersson, Roland (2016)
    Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.