Browsing by Subject "CLINICAL-PRACTICE GUIDELINES"

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  • Sartelli, Massimo; Di Bella, Stefano; McFarland, Lynne V.; Khanna, Sahil; Furuya-Kanamori, Luis; Abuzeid, Nadir; Abu-Zidan, Fikri M.; Ansaloni, Luca; Augustin, Goran; Bala, Miklosh; Ben-Ishay, Offir; Biffl, Walter L.; Brecher, Stephen M.; Camacho-Ortiz, Adrian; Cainzos, Miguel A.; Chan, Shirley; Cherry-Bukowiec, Jill R.; Clanton, Jesse; Coccolini, Federico; Cocuz, Maria E.; Coimbra, Raul; Cortese, Francesco; Cui, Yunfeng; Czepiel, Jacek; Demetrashvili, Zaza; Di Carlo, Isidoro; Di Saverio, Salomone; Dumitru, Irina M.; Eckmann, Christian; Eiland, Edward H.; Forrester, Joseph D.; Fraga, Gustavo P.; Frossard, Jean L.; Fry, Donald E.; Galeiras, Rita; Ghnnam, Wagih; Gomes, Carlos A.; Griffiths, Ewen A.; Guirao, Xavier; Ahmed, Mohamed H.; Herzog, Torsten; Kim, Jae Il; Iqbal, Tariq; Isik, Arda; Itani, Kamal M. F.; Labricciosa, Francesco M.; Lee, Yeong Y.; Juang, Paul; Karamarkovic, Aleksandar; Kim, Peter K.; Kluger, Yoram; Leppäniemi, Ari; Lohsiriwat, Varut; Machain, Gustavo M.; Marwah, Sanjay; Mazuski, John E.; Metan, Gokhan; Moore, Ernest E.; Moore, Frederick A.; Ordonez, Carlos A.; Pagani, Leonardo; Petrosillo, Nicola; Portela, Francisco; Rasa, Kemal; Rems, Miran; Sakakushev, Boris E.; Segovia-Lohse, Helmut; Sganga, Gabriele; Shelat, Vishal G.; Spigaglia, Patrizia; Tattevin, Pierre; Trana, Cristian; Urbanek, Libor; Ulrych, Jan; Viale, Pierluigi; Baiocchi, Gian L.; Catena, Fausto (2019)
    In the last three decades, Clostridium difficile infection (CDI) has increased in incidence and severity in many countries worldwide. The increase in CDI incidence has been particularly apparent among surgical patients. Therefore, prevention of CDI and optimization of management in the surgical patient are paramount. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of CDI in surgical patients according to the most recent available literature. The update includes recent changes introduced in the management of this infection.
  • MISiCOL Task Force (2018)
    Aim: To investigate the rate of laparoscopic colectomies for colon cancer using registries and population based studies. To provide a position paper on mini-invasive (MIS) colon cancer surgery based on the opinion of experts leader in this field. Methods: A systematic review of the literature was conducted using PRISMA guidelines for the rate of laparoscopy in colon cancer. Moreover, Delphi methodology was used to reach consensus among 35 international experts in four study rounds. Consensus was defined as an agreement >= 75.0%. Domains of interest included nosology, essential technical/oncological requirements, outcomes and MIS training. Results: Forty-four studies from 42 articles were reviewed. Although it is still sub-optimal, the rate of MIS for colon cancer increased over the years and it is currently >50% in Korea, Netherlands, UK and Australia. The remaining European countries are un-investigated and presented lower rates with highest variations, ranging 7-35%. Using Delphi methodology, a laparoscopic colectomy was defined as a "colon resection performed using key-hole surgery independently from the type of anastomosis". The panel defined also the oncological requirements recognized essential for the procedure and agreed that when performed by experienced surgeons, it should be marked as best practice in guidelines, given the principles of oncologic surgery be respected (RO procedure, vessel ligation and mesocolon integrity). Conclusion: The rate of MIS colectomies for cancer in Europe should be further investigated. A panel of leaders in this field defined laparoscopic colectomy as a best practice procedure when performed by an experienced surgeon respecting the standards of surgical oncology. (C) 2018 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
  • Bjorck, M.; Kirkpatrick, A. W.; Cheatham, M.; Kaplan, M.; Leppäniemi, Ari; De Waele, J. J. (2016)
    Background: In 2009, a classification system for the open abdomen was introduced. The aim of such a classification is to aid the (1) description of the patient's clinical course; (2) standardization of clinical guidelines for guiding open abdomen management; and (3) facilitation of comparisons between studies and heterogeneous patient populations, thus serving as an aid in clinical research. Methods: As part of the revision of the definitions and clinical guidelines performed by the World Society of the Abdominal Compartment Syndrome, this 2009 classification system was amended following a review of experiences in teaching and research and published as part of updated consensus statements and clinical practice guidelines in 2013. Among 29 articles citing the 2009 classification system, nine were cohort studies. They were reviewed as part of the classification revision process. A total of 542 patients (mean: 60, range: 9-160) had been classified. Two problems with the previous classification system were identified: the definition of enteroatmospheric fistulae, and that an enteroatmospheric fistula was graded less severe than a frozen abdomen. Results: The following amended classification was proposed: Grade 1, without adherence between bowel and abdominal wall or fixity of the abdominal wall (lateralization), subdivided as follows: 1A, clean; 1B, contaminated; and 1C, with enteric leak. An enteric leak controlled by closure, exteriorization into a stoma, or a permanent enterocutaneous fistula is considered clean. Grade 2, developing fixation, subdivided as follows: 2A, clean; 2B, contaminated; and 2C, with enteric leak. Grade 3, frozen abdomen, subdivided as follows: 3A clean and 3B contaminated. Grade 4, an established enteroatmospheric fistula, is defined as a permanent enteric leak into the open abdomen, associated with granulation tissue. Conclusions: The authors believe that, with these changes, the requirements on a functional and dynamic classification system, useful in both research and training, will be fulfilled. We encourage future investigators to apply the system and report on its merits and constraints.
  • Sartelli, Massimo; Weber, Dieter G.; Ruppe, Etienne; Bassetti, Matteo; Wright, Brian J.; Ansaloni, Luca; Catena, Fausto; Coccolini, Federico; Abu-Zidan, Fikri M.; Coimbra, Raul; Moore, Ernest E.; Moore, Frederick A.; Maier, Ronald V.; De Waele, Jan J.; Kirkpatrick, Andrew W.; Griffiths, Ewen A.; Eckmann, Christian; Brink, Adrian J.; Mazuski, John E.; May, Addison K.; Sawyer, Rob G.; Mertz, Dominik; Montravers, Philippe; Kumar, Anand; Roberts, Jason A.; Vincent, Jean-Louis; Watkins, Richard R.; Lowman, Warren; Spellberg, Brad; Abbott, Iain J.; Adesunkanmi, Abdulrashid Kayode; Al-Dahir, Sara; Al-Hasan, Majdi N.; Agresta, Ferdinando; Althani, Asma A.; Ansari, Shamshul; Ansumana, Rashid; Augustin, Goran; Bala, Miklosh; Balogh, Zsolt J.; Baraket, Oussama; Bhangu, Aneel; Beltran, Marcelo A.; Bernhard, Michael; Biffl, Walter L.; Boermeester, Marja A.; Brecher, Stephen M.; Cherry-Bukowiec, Jill R.; Buyne, Otmar R.; Cainzos, Miguel A.; Cairns, Kelly A.; Camacho-Ortiz, Adrian; Chandy, Sujith J.; Jusoh, Asri Che; Chichom-Mefire, Alain; Colijn, Caroline; Corcione, Francesco; Cui, Yunfeng; Curcio, Daniel; Delibegovic, Samir; Demetrashvili, Zaza; De Simone, Belinda; Dhingra, Sameer; Diaz, Jose J.; Di Carlo, Isidoro; Dillip, Angel; Di Saverio, Salomone; Doyle, Michael P.; Dorj, Gereltuya; Dogjani, Agron; Dupont, Herve; Eachempati, Soumitra R.; Enani, Mushira Abdulaziz; Egiev, Valery N.; Elmangory, Mutasim M.; Ferrada, Paula; Fitchett, Joseph R.; Fraga, Gustavo P.; Guessennd, Nathalie; Giamarellou, Helen; Ghnnam, Wagih; Gkiokas, George; Goldberg, Staphanie R.; Gomes, Carlos Augusto; Gomi, Harumi; Guzman-Blanco, Manuel; Haque, Mainul; Hansen, Sonja; Hecker, Andreas; Heizmann, Wolfgang R.; Herzog, Torsten; Hodonou, Adrien Montcho; Hong, Suk-Kyung; Kafka-Ritsch, Reinhold; Kaplan, Lewis J.; Kapoor, Garima; Karamarkovic, Aleksandar; Kees, Martin G.; Kenig, Jakub; Kiguba, Ronald; Kim, Peter K.; Kluger, Yoram; Khokha, Vladimir; Koike, Kaoru; Kok, Kenneth Y. Y.; Kong, Victory; Knox, Matthew C.; Inaba, Kenji; Isik, Arda; Iskandar, Katia; Ivatury, Rao R.; Labbate, Maurizio; Labricciosa, Francesco M.; Laterre, Pierre-Francois; Latifi, Rifat; Lee, Jae Gil; Lee, Young Ran; Leone, Marc; Leppäniemi, Ari; Li, Yousheng; Liang, Stephen Y.; Loho, Tonny; Maegele, Marc; Malama, Sydney; Marei, Hany E.; Martin-Loeches, Ignacio; Marwah, Sanjay; Massele, Amos; McFarlane, Michael; Melo, Renato Bessa; Negoi, Ionut; Nicolau, David P.; Nord, Carl Erik; Ofori-Asenso, Richard; Omari, AbdelKarim H.; Ordonez, Carlos A.; Ouadii, Mouaqit; Pereira Junior, Gerson Alves; Piazza, Diego; Pupelis, Guntars; Rawson, Timothy Miles; Rems, Miran; Rizoli, Sandro; Rocha, Claudio; Sakakhushev, Boris; Sanchez-Garcia, Miguel; Sato, Norio; Lohse, Helmut A. Segovia; Sganga, Gabriele; Siribumrungwong, Boonying; Shelat, Vishal G.; Soreide, Kjetil; Soto, Rodolfo; Talving, Peep; Tilsed, Jonathan V.; Timsit, Jean-Francois; Trueba, Gabriel; Trung, Ngo Tat; Ulrych, Jan; van Goor, Harry; Vereczkei, Andras; Vohra, Ravinder S.; Wani, Imtiaz; Uhl, Waldemar; Xiao, Yonghong; Yuan, Kuo-Ching; Zachariah, Sanoop K.; Zahar, Jean-Ralph; Zakrison, Tanya L.; Corcione, Antonio; Melotti, Rita M.; Viscoli, Claudio; Viale, Perluigi (2016)
    Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.
  • Bousquet, J.; Hellings, P. W.; Agache, I.; Bedbrook, A.; Bachert, C.; Bergmann, K. C.; Bewick, M.; Bindslev-Jensen, C.; Bosnic-Anticevitch, S.; Bucca, C.; Caimmi, D. P.; Camargos, P. A. M.; Canonica, G. W.; Casale, T.; Chavannes, N. H.; Cruz, A. A.; De Carlo, G.; Dahl, R.; Demoly, P.; Devillier, P.; Fonseca, J.; Fokkens, W. J.; Guldemond, N. A.; Haahtela, T.; Illario, M.; Just, J.; Keil, T.; Klimek, L.; Kuna, P.; Larenas-Linnemann, D.; Morais-Almeida, M.; Mullol, J.; Murray, R.; Naclerio, R.; O'Hehir, R. E.; Papadopoulos, N. G.; Pawankar, R.; Potter, P.; Ryan, D.; Samolinski, B.; Schunemann, H. J.; Sheikh, A.; Simons, F. E. R.; Stellato, C.; Todo-Bom, A.; Tomazic, P. V.; Valiulis, A.; Valovirta, E.; Ventura, M. T.; Wickman, M.; Young, I.; Yorgancioglu, A.; Zuberbier, T.; Aberer, W.; Akdis, C. A.; Akdis, M.; Annesi-Maesano, I.; Ankri, J.; Ansotegui, I. J.; Anto, J. M.; Arnavielhe, S.; Asarnoj, A.; Arshad, H.; Avolio, F.; Baiardini, I.; Barbara, C.; Barbagallo, M.; Bateman, E. D.; Beghe, B.; Bel, E. H.; Bennoor, K. S.; Benson, M.; Bialoszewski, A. Z.; Bieber, T.; Bjermer, L.; Blain, H.; Blasi, F.; Boner, A. L.; Bonini, M.; Bonini, S.; Bosse, I.; Bouchard, J.; Boulet, L. P.; Bourret, R.; Bousquet, P. J.; Braido, F.; Briggs, A. H.; Brightling, C. E.; Brozek, J.; Buhl, R.; Bunu, C.; Burte, E.; Bush, A.; Caballero-Fonseca, F.; Calderon, M. A.; Camuzat, T.; Cardona, V.; Carreiro-Martins, P.; Carriazo, A. M.; Carlsen, K. H.; Carr, W.; Cepeda Sarabia, A. M.; Cesari, M.; Chatzi, L.; Chiron, R.; Chivato, T.; Chkhartishvili, E.; Chuchalin, A. G.; Chung, K. F.; Ciprandi, G.; Correia de Sousa, J.; Cox, L.; Crooks, G.; Custovic, A.; Dahlen, S. E.; Darsow, U.; Dedeu, T.; Deleanu, D.; Denburg, J. A.; De Vries, G.; Didier, A.; Dinh-Xuan, A. T.; Dokic, D.; Douagui, H.; Dray, G.; Dubakiene, R.; Durham, S. R.; Du Toit, G.; Dykewicz, M. S.; Eklund, P.; El-Gamal, Y.; Ellers, E.; Emuzyte, R.; Farrell, J.; Wagner, A. Fink; Fiocchi, A.; Fletcher, M.; Forastiere, F.; Gaga, M.; Gamkrelidze, A.; Gemicioglu, B.; Gereda, J. E.; van Wick, R. Gerth; Gonzalez Diaz, S.; Grisle, I.; Grouse, L.; Gutter, Z.; Guzman, M. A.; Hellquist-Dahl, B.; Heinrich, J.; Horak, F.; Hourihane, J. O'. B.; Humbert, M.; Hyland, M.; Iaccarino, G.; Jares, E. J.; Jeandel, C.; Johnston, S. L.; Joos, G.; Jonquet, O.; Jung, K. S.; Jutel, M.; Kaidashev, I.; Khaitov, M.; Kalayci, O.; Kalyoncu, A. F.; Kardas, P.; Keith, P. K.; Kerkhof, M.; Kerstjens, H. A. M.; Khaltaev, N.; Kogevinas, M.; Kolek, V.; Koppelman, G. H.; Kowalski, M. L.; Kuitunen, M.; Kull, I.; Kvedariene, V.; Lambrecht, B.; Lau, S.; Laune, D.; Le, L. T. T.; Lieberman, P.; Lipworth, B.; Li, J.; Carlsen, K. C. Lodrup; Louis, R.; Lupinek, C.; MacNee, W.; Magar, Y.; Magnan, A.; Mahboub, B.; Maier, D.; Majer, I.; Malva, J.; Manning, P.; De Manuel Keenoy, E.; Marshall, G. D.; Masjedi, M. R.; Mathieu-Dupas, E.; Maurer, M.; Mavale-Manuel, S.; Melen, E.; Melo-Gomes, E.; Meltzer, E. O.; Mercier, J.; Merk, H.; Miculinic, N.; Mihaltan, F.; Milenkovic, B.; Millot-Keurinck, J.; Mohammad, Y.; Momas, I.; Mosges, R.; Muraro, A.; Namazova-Baranova, L.; Nadif, R.; Neffen, H.; Nekam, K.; Nieto, A.; Niggemann, B.; Nogueira-Silva, L.; Nogues, M.; Nyembue, T. D.; Ohta, K.; Okamoto, Y.; Okubo, K.; Olive-Elias, M.; Ouedraogo, S.; Paggiaro, P.; Pali-Schoell, I.; Palkonen, S.; Panzner, P.; Papi, A.; Park, H. S.; Passalacqua, G.; Pedersen, S.; Pereira, A. M.; Pfaar, O.; Picard, R.; Pigearias, B.; Pin, I.; Plavec, D.; Pohl, W.; Popov, T. A.; Portejoie, F.; Postma, D.; Poulsen, L. K.; Price, D.; Rabe, K. F.; Raciborski, F.; Roberts, G.; Robalo-Cordeiro, C.; Rodenas, F.; Rodriguez-Manas, L.; Rolland, C.; Roman Rodriguez, M.; Romano, A.; Rosado-Pinto, J.; Rosario, N.; Rottem, M.; Sanchez-Borges, M.; Sastre-Dominguez, J.; Scadding, G. K.; Scichilone, N.; Schmid-Grendelmeier, P.; Serrano, E.; Shields, M.; Siroux, V.; Sisul, J. C.; Skrindo, I.; Smit, H. A.; Sole, D.; Sooronbaev, T.; Spranger, O.; Stelmach, R.; Sterk, P. J.; Strandberg, T.; Sunyer, J.; Thijs, C.; Triggiani, M.; Valenta, R.; Valero, A.; van Eerd, M.; van Ganse, E.; van Hague, M.; Vandenplas, O.; Varona, L. L.; Vellas, B.; Vezzani, G.; Vazankari, T.; Viegi, G.; Vontetsianos, T.; Wagenmann, M.; Walker, S.; Wang, D. Y.; Wahn, U.; Werfel, T.; Whalley, B.; Williams, D. M.; Williams, S.; Wilson, N.; Wright, J.; Yawn, B. P.; Yiallouros, P. K.; Yusuf, O. M.; Zaidi, A.; Zar, H. J.; Zernotti, M. E.; Zhang, L.; Zhong, N.; Zidarn, M. (2016)
    The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA-disseminated and implemented in over 70 countries globally-is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease.
  • Bousquet, J.; Onorato, G. L.; Bachert, C.; Barbolini, M.; Bedbrook, A.; Bjermer, L.; de Sousa, J. Correia; Chavannes, N. H.; Cruz, A. A.; Keenoy, E. De Manuel; Devillier, P.; Fonseca, J.; Hun, S.; Kostka, T.; Hellings, P. W.; Illario, M.; Ivancevich, J. C.; Larenas-Linnemann, D.; Millot-Keurinck, J.; Ryan, D.; Samolinski, B.; Sheikh, A.; Yorgancioglu, A.; Agache, I.; Arnavielhe, S.; Bewick, M.; Annesi-Maesano, I.; Anto, J. M.; Bergmann, K. C.; Bindslev-Jensen, C.; Bosnic-Anticevich, S.; Bouchard, J.; Caimmi, D. P.; Camargos, P.; Canonica, G. W.; Cardona, V.; Carriazo, A. M.; Cingi, C.; Colgan, E.; Custovic, A.; Dahl, R.; Demoly, P.; De Vries, G.; Fokkens, W. J.; Fontaine, J. F.; Gemicioglu, B.; Guldemond, N.; Gutter, Z.; Haahtela, T.; Hellqvist-Dahl, B.; Jares, E.; Joos, G.; Just, J.; Khaltaev, N.; Keil, T.; Klimek, L.; Kowalski, M. L.; Kull, I.; Kuna, P.; Kvedariene, V.; Laune, D.; Louis, R.; Magnan, A.; Malva, J.; Mathieu-Dupas, E.; Melen, E.; Menditto, E.; Morais-Almeida, M.; Mosges, R.; Mullol, J.; Murray, R.; Neffen, H.; O'Hehir, R.; Palkonen, S.; Papadopoulos, N. G.; Passalacqua, G.; Pepin, J. L.; Portejoie, F.; Price, D.; Pugin, B.; Raciborski, F.; Simons, F. E. R.; Sova, M.; Spranger, O.; Stellato, C.; Bom, A. Todo; Tomazic, P. V.; Triggiani, M.; Valero, A.; Valovirta, E.; VandenPlas, O.; Valiulis, A.; Van Eerd, M.; Ventura, M. T.; Wickman, M.; Young, I.; Zuberbier, T.; Zurkuhlen, A.; Senn, A. (2017)
    A Good Practice is a practice that works well, produces good results, and is recommended as a model. MACVIA-ARIA Sentinel Network (MASK), the new Allergic Rhinitis and its Impact on Asthma (ARIA) initiative, is an example of a Good Practice focusing on the implementation of multi-sectoral care pathways using emerging technologies with real life data in rhinitis and asthma multi-morbidity. The European Union Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS) has developed a checklist of 28 items for the evaluation of Good Practices. SUNFRAIL (Reference Sites Network for Prevention and Care of Frailty and Chronic Conditions in community dwelling persons of EU Countries), a European Union project, assessed whether MASK is in line with the 28 items of JA-CHRODIS. A short summary was proposed for each item and 18 experts, all members of ARIA and SUNFRAIL from 12 countries, assessed the 28 items using a Survey Monkey-based questionnaire. A visual analogue scale (VAS) from 0 (strongly disagree) to 100 (strongly agree) was used. Agreement equal or over 75% was observed for 14 items (50%). MASK is following the JA-CHRODIS recommendations for the evaluation of Good Practices.
  • Kurko, Terhi; Linden, Kari; Pietila, Kirsi; Sandstrom, Patrick; Airaksinen, Marja (2010)
  • Sartelli, Massimo; Catena, Fausto; Di Saverio, Salomone; Ansaloni, Luca; Malangoni, Mark; Moore, Ernest E.; Moore, Frederick A.; Ivatury, Rao; Coimbra, Raul; Leppaniemi, Ari; Biffl, Walter; Kluger, Yoram; Fraga, Gustavo P.; Ordonez, Carlos A.; Marwah, Sanjay; Gerych, Igor; Lee, Jae Gil; Trana, Cristian; Coccolini, Federico; Corradetti, Francesco; Kirkby-Bott, James (2014)
  • Beets, Geerard; Sebag-Montefiore, David; Andritsch, Elisabeth; Arnold, Dirk; Beishon, Marc; Crul, Mirjam; Dekker, Jan Willem; Delgado-Bolton, Roberto; Flejou, Jean-Francois; Grisold, Wolfgang; Henning, Geoffrey; Laghi, Andrea; Lovey, Jozsef; Negrouk, Anastassia; Pereira, Philippe; Roca, Pierre; Saarto, Tiina; Seufferlein, Thomas; Taylor, Claire; Ugolini, Giampaolo; van de Velde, Cornelis; van Herck, Bert; Yared, Wendy; Costa, Alberto; Naredi, Peter (2017)
    Background: ECCO essential requirements for quality cancer care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to patients who have a specific tumour type. They are written by European experts representing all disciplines involved in cancer care. ERQCC papers give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high quality of care throughout the patient journey. References are made to clinical guidelines and other resources where appropriate, and the focus is on care in Europe. Colorectal cancer: essential requirements for quality care Colorectal cancer (CRC) is the second most common cause of cancer death in Europe and has wide variation in outcomes among countries. Increasing numbers of older people are contracting the disease, and treatments for advanced stages are becoming more complex. A growing number of survivors also require specialist support. High-quality care can only be a carried out in specialised CRC units or centres which have both a core multidisciplinary team and an extended team of allied professionals, and which are subject to quality and audit procedures. Such units or centres are far from universal in all European countries. It is essential that, to meet European aspirations for comprehensive cancer control, healthcare organisations implement the essential requirements in this paper, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship. Conclusion: Taken together, the information presented in this paper provides a comprehensive description of the essential requirements for establishing a high-quality CRC service. The ECCO expert group is aware that it is not possible to propose a 'one size fits all' system for all countries, but urges that access to multidisciplinary units or centres must be guaranteed for all those with CRC. (C) 2016 The Authors. Published by Elsevier Ireland Ltd.
  • Wouters, Michel W.; Michielin, Olivier; Bastiaannet, Esther; Beishon, Marc; Catalano, Orlando; del Marmol, Veronique; Delgado-Bolton, Roberto; Dendale, Remi; Trill, Maria Die; Ferrari, Andrea; Forsea, Ana-Maria; Kreckel, Hannelore; Lövey, Jozsef; Luyten, Gre; Massi, Daniela; Mohr, Peter; Oberst, Simon; Pereira, Philippe; Paiva Prata, Joao Paulo; Rutkowski, Piotr; Saarto, Tiina; Sheth, Sapna; Spurrier-Bernard, Gilly; Vuoristo, Meri-Sisko; Costad, Alberto; Naredi, Peter (2018)
    Background ECCO essential requirements for quality cancer care (ERQCC) are explanations and descriptions of challenges, organisation and actions that are necessary to give high-quality care to patients who have a specific type of cancer. They are written by European experts representing all disciplines involved in cancer care. ERQCC papers give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high quality of care throughout the patient journey. References are made to clinical guidelines and other resources where appropriate, and the focus is on care in Europe. Melanoma: essential requirements for quality care: Melanoma, the most-deadly skin cancer, is rising in incidence among fair-skinned people in Europe. Increasing complexity of care for advanced disease in clinical areas such as staging and new therapies requires attention to a number of challenges and inequalities in a diverse patient group. Care for advanced melanoma must only be carried out in, or in collaboration with, specialist melanoma centres which have both a core multidisciplinary team and an extended team of allied professionals, and which are subject to quality and audit procedures. Access to such units is far from universal in all European countries. It is essential that, to meet European aspirations for high-quality comprehensive cancer control, healthcare organisations implement the requirements in this paper, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis to treatment and follow-up, to improve survival and quality of life for patients. Conclusion: Taken together, the information presented in this paper provides a comprehensive description of the essential requirements for establishing a high-quality service for melanoma. The ERQCC expert group is aware that it is not possible to propose a 'one size fits all' system for all countries, but urges that access to multidisciplinary teams and specialised treatments is guaranteed to all patients with melanoma.
  • Allum, William; Lordick, Florian; Alsina, Maria; Andritsch, Elisabeth; Ba-Ssalamah, Ahmed; Beishon, Marc; Braga, Marco; Caballero, Carmela; Carneiro, Fatima; Cassinello, Fernando; Dekker, Jan Willem; Delgado-Bolton, Roberto; Haustermans, Karin; Henning, Geoffrey; Hutter, Bettina; Lovey, Jozsef; Netikova, Irena Stenglova; Oberrnannova, Radka; Oberst, Simon; Rostoft, Siri; Saarto, Tiina; Seufferlein, Thomas; Sheth, Sapna; Wynter-Blyth, Venetia; Costa, Alberto; Naredi, Peter Z. (2018)
    Background: ECCO essential requirements for quality cancer care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to patients who have a specific type of cancer. They are written by European experts representing all disciplines involved in cancer care. ERQCC papers give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high quality of care throughout the patient journey. References are made to clinical guidelines and other resources where appropriate, and the focus is on care in Europe. Oesophageal and gastric: essential requirements for quality care: Oesophageal and gastric (OG) cancers are a challenging tumour group with a poor prognosis and wide variation in outcomes among European countries. Increasing numbers of older people are contracting the diseases, and treatments and care pathways are becoming more complex in both curative and palliative settings. High-quality care can only be a carried out in specialised OG cancer units or centres which have both a core multidisciplinary team and an extended team of allied professionals, and which are subject to quality and audit procedures. Such units or centres are far from universal in all European countries. It is essential that, to meet European aspirations for comprehensive cancer control, healthcare organisations implement the essential requirements in this paper, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship. Conclusion: Taken together, the information presented in this paper provides a comprehensive description of the essential requirements for establishing a high-quality OG cancer service. The ERQCC expert group is aware that it is not possible to propose a one size fits all' system for all countries, but urges that access to multidisciplinary units or centres must be guaranteed for all those with OG cancer.
  • Andritsch, Elisabeth; Beishon, Marc; Bielack, Stefan; Bonvalot, Sylvie; Casali, Paolo; Crul, Mirjam; Delgado-Bolton, Roberto; Donatih, Davide Maria; Douis, Hassan; Haas, Rick; Hogendoorn, Pancras; Kozhaeva, Olga; Lavender, Verna; Lovey, Jozsef; Negrouk, Anastassia; Pereira, Philippe; Roca, Pierre; de Lempdes, Godelieve Rochette; Saarto, Tiina; van Berck, Bert; Vassal, Gilles; Wartenberg, Markus; Yared, Wendy; Costa, Alberto; Naredi, Peter (2017)
    Background: ECCO essential requirements for quality cancer care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to patients who have a specific tumour type. They are written by European experts representing all disciplines involved in cancer care. ERQCC papers give oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high quality of care throughout the patient journey. References are made to clinical guidelines and other resources where appropriate, and the focus is on care in Europe. Sarcoma: essential requirements for quality care Sarcomas - which can be classified into soft tissue and bone sarcomas - are rare, but all rare cancers make up more than 20% of cancers in Europe, and there are substantial inequalities in access to high-quality care. Sarcomas, of which there are many subtypes, comprise a particularly complex and demanding challenge for healthcare systems and providers. This paper presents essential requirements for quality cancer care of soft tissue sarcomas in adults and bone sarcomas. High-quality care must only be carried out in specialised sarcoma centres (including paediatric cancer centres) which have both a core multidisciplinary team and an extended team of allied professionals, and which are subject to quality and audit procedures. Access to such units is far from universal in all European countries. It is essential that, to meet European aspirations for high-quality comprehensive cancer control, healthcare organisations implement the requirements in this paper, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis and follow-up, to treatment, to improve survival and quality of life for patients. Conclusion: Taken together, the information presented in this paper provides a comprehensive description of the essential requirements for establishing a high-quality service for soft tissue sarcomas in adults and bone sarcomas. The ECCO expert group is aware that it is not possible to propose a 'one size fits all' system for all countries, but urges that access to multidisciplinary teams is guaranteed to all patients with sarcoma. (C) 2016 The Authors. Published by Elsevier Ireland Ltd.
  • Sullivan, Kathleen E.; Bassiri, Hamid; Bousfiha, Ahmed A.; Costa-Carvalho, Beatriz T.; Freeman, Alexandra F.; Hagin, David; Lau, Yu L.; Lionakis, Michail S.; Moreira, Ileana; Pinto, Jorge A.; de Moraes-Pinto, M. Isabel; Rawat, Amit; Reda, Shereen M.; Lugo Reyes, Saul Oswaldo; Seppanen, Mikko; Tang, Mimi L. K. (2017)
    In today's global economy and affordable vacation travel, it is increasingly important that visitors to another country and their physician be familiar with emerging infections, infections unique to a specific geographic region, and risks related to the process of travel. This is never more important than for patients with primary immunodeficiency disorders (PIDD). A recent review addressing common causes of fever in travelers provides important information for the general population Thwaites and Day (N Engl J Med 376:548-560, 2017). This review covers critical infectious and management concerns specifically related to travel for patients with PIDD. This review will discuss the context of the changing landscape of infections, highlight specific infections of concern, and profile distinct infection phenotypes in patients who are immune compromised. The organization of this review will address the environment driving emerging infections and several concerns unique to patients with PIDD. The first section addresses general considerations, the second section profiles specific infections organized according to mechanism of transmission, and the third section focuses on unique phenotypes and unique susceptibilities in patients with PIDDs. This review does not address most parasitic diseases. Reference tables provide easily accessible information on a broader range of infections than is described in the text.
  • MASK Study Grp; Bousquet, J.; Bedbrook, A.; Czarlewski, W.; Haahtela, T.; Valovirta, E.; Vasankari, T.; Toppila-Salmi, S.; Salimäki, Johanna; Kuitunen, M.; Wallace, D. V. (2019)
    AimsMobile Airways Sentinel NetworK (MASK) belongs to the Fondation Partenariale MACVIA-LR of Montpellier, France and aims to provide an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity across the life cycle, whatever their gender or socio-economic status, in order to reduce health and social inequities incurred by the disease and to improve the digital transformation of health and care. The ultimate goal is to change the management strategy in chronic diseases.MethodsMASK implements ICT technologies for individualized and predictive medicine to develop novel care pathways by a multi-disciplinary group centred around the patients.StakeholdersInclude patients, health care professionals (pharmacists and physicians), authorities, patient's associations, private and public sectors.ResultsMASK is deployed in 23 countries and 17 languages. 26,000 users have registered.EU grants (2018)MASK is participating in EU projects (POLLAR: impact of air POLLution in Asthma and Rhinitis, EIT Health, DigitalHealthEurope, Euriphi and Vigour).Lessons learnt(i) Adherence to treatment is the major problem of allergic disease, (ii) Self-management strategies should be considerably expanded (behavioural), (iii) Change management is essential in allergic diseases, (iv) Education strategies should be reconsidered using a patient-centred approach and (v) Lessons learnt for allergic diseases can be expanded to chronic diseases.
  • Koskenvuo, Laura; Lehtonen, Taru; Koskensalo, Selja; Rasilainen, Suvi; Klintrup, Kai; Ehrlich, Anu; Pinta, Tarja; Scheinin, Tom; Sallinen, Ville (2019)
    Background Decreased surgical site infections (SSIs) and morbidity have been reported with mechanical and oral antibiotic bowel preparation (MOABP) compared with no bowel preparation (NBP) in colonic surgery. Several societies have recommended routine use of MOABP in patients undergoing colon resection on the basis of these data. Our aim was to investigate this recommendation in a prospective randomised context. Methods In this multicentre, parallel, single-blinded trial, patients undergoing colon resection were randomly assigned (1: 1) to either MOABP or NBP in four hospitals in Finland, using a web-based randomisation technique. Randomly varying block sizes (four, six, and eight) were used for randomisation, and stratification was done according to centre. The recruiters, treating physicians, operating surgeons, data collectors, and analysts were masked to the allocated treatment. Key exclusion criteria were need for emergency surgery; bowel obstruction; colonoscopy planned during surgery; allergy to polyethylene glycol, neomycin, or metronidazole; and age younger than 18 years or older than 95 years. Study nurses opened numbered opaque envelopes containing the patient allocated group, and instructed the patients according to the allocation group to either prepare the bowel, or not prepare the bowel. Patients allocated to MOABP prepared their bowel by drinking 2 L of polyethylene glycol and 1 L of clear fluid before 6 pm on the day before surgery and took 2 g of neomycin orally at 7 pm and 2 g of metronidazole orally at 11 pm the day before surgery. The primary outcome was SSI within 30 days after surgery, analysed in the modified intention-to-treat population (all patients who were randomly allocated to and underwent elective colon resection with an anastomosis) along with safety analyses. The trial is registered with ClinicalTrials. gov, NCT02652637, and EudraCT, 2015-004559-38, and is closed to new participants. Findings Between March 17, 2016, and Aug 20, 2018, 738 patients were assessed for eligibility. Of the 417 patients who were randomised (209 to MOABP and 208 to NBP), 13 in the MOABP group and eight in the NBP were excluded before undergoing colonic resection; therefore, the modified intention-to-treat analysis included 396 patients (196 for MOABP and 200 for NBP). SSI was detected in 13 (7%) of 196 patients randomised to MOABP, and in 21 (11%) of 200 patients randomised to NBP (odds ratio 1 . 65, 95% CI 0 . 80-3 . 40; p= 0 . 17). Anastomotic dehiscence was reported in 7 (4%) of 196 patients in the MOABP group and in 8 (4%) of 200 in the NBP group, and reoperations were necessary in 16 (8%) of 196 compared with 13 (7%) of 200 patients. Two patients died in the NBP group and none in the MOABP group within 30 days. Interpretation MOABP does not reduce SSIs or the overall morbidity of colon surgery compared with NBP. We therefore propose that the current recommendations of using MOABP for colectomies to reduce SSIs or morbidity should be reconsidered. Copyright (c) 2019 Elsevier Ltd. All rights reserved.
  • Eriksson, Mikael; Reichardt, Peter; Hall, Kirsten Sundby; Schutte, Jochen; Cameron, Silke; Hohenberger, Peter; Bauer, Sebastian; Leinonen, Mika; Reichardt, Annette; Davis, Maria Rejmyr; Alvegard, Thor; Joensuu, Heikki (2016)
    Purpose: Preoperative percutaneous transabdominal wall biopsy may be considered to diagnose gastrointestinal stromal tumour (GIST) and plan preoperative treatment with tyrosine kinase inhibitors when an endoscopic biopsy is not possible. Hypothetically, a transabdominal wall biopsy might lead to cell seeding and conversion of a local GIST to a disseminated one. We investigated the influence of preoperative needle biopsy on survival outcomes. Methods: We collected the clinical data from hospital case records of the 397 patients who participated in the Scandinavian Sarcoma Group (SSG) XVIII/Arbeitsgemeinschaft Internistische Onkologie (AIO) randomised trial and who had a transabdominal fine needle and/or core needle biopsy carried out prior to study entry. The SSG XVIII/AIO trial compared 1 and 3 years of adjuvant imatinib in a patient population with a high risk of GIST recurrence after macroscopically radical surgery. The primary end-point was recurrence-free survival (RFS), and the secondary end-points included overall survival (OS). Results: A total of 47 (12.0%) out of the 393 patients with data available underwent a percutaneous biopsy. No significant difference in RFS or OS was found between the patients who underwent or did not undergo a percutaneous biopsy either in the entire series or in subpopulation analyses, except for a statistically significant RFS advantage for patients who had a percutaneous biopsy and a tumour >= 10 cm in diameter. Conclusion: A preoperative diagnostic percutaneous biopsy of a suspected GIST may not increase the risk for GIST recurrence in a patient population who receive adjuvant imatinib after the biopsy. (C) 2016 Elsevier Ltd. All rights reserved.
  • Barrenetxea Lekue, Cristina; Grasso Cicala, Silvina; Leppä, Sirpa; Stauffer Larsen, Thomas; Herráez Rodríguez, Susana; Alonso Caballero, Clara; Jørgensen, Judit M.; Toldbod, Helle; Leal Martínez, Irene; D’Amore, Francesco (2019)
    Outcomes for patients with non-Hodgkin’s lymphoma (NHL) that proves refractory to treatment remain poor. Treatment of such patients is individualized and can include enrolment in a clinical trial of novel agents or use of one of a wide array of drug regimens. Initial treatment with anthracyclines such as doxorubicin limits options at later stages of treatment because of anthracycline-related cumulative cardiotoxicity. The aza-anthracenedione pixantrone was developed to reduce the likelihood of cardiotoxicity without compromising efficacy and is currently conditionally approved for use as monotherapy in patients with multiply-relapsed or refractory aggressive B cell NHL. The use of pixantrone in combination therapy, often to replace doxorubicin or mitoxantrone, has or is currently being investigated in numerous studies in patients with aggressive or indolent NHL and is the focus of this review. These include the R-CPOP regimen (rituximab, cyclophosphamide, pixantrone, vincristine, prednisone) for aggressive NHL in the first-line setting, including a study in elderly patients with limited cardiac function, and for patients with relapsed NHL with prior anthracycline exposure; the PSHAP regimen (pixantrone, cytarabine, prednisone, cisplatin), also in the latter setting; the PREBen/PEBen regimen (pixantrone, bendamustine and etoposide with or without rituximab) as salvage therapy; and pixantrone in combination with fludarabine, dexamethasone, and rituximab (FPD-R) for relapsed indolent NHL.
  • Skinner, Roderick; Mulder, Renee L.; Kremer, Leontien C.; Hudson, Melissa M.; Constine, Louis S.; Bardi, Edit; Boekhout, Annelies; Borgmann-Staudt, Anja; Brown, Morven C.; Cohn, Richard; Dirksen, Uta; Giwercman, Alexsander; Ishiguro, Hiroyuki; Jahnukainen, Kirsi; Kenney, Lisa B.; Loonen, Jacqueline J.; Meacham, Lilian; Neggers, Sebastian; Nussey, Stephen; Petersen, Cecilia; Shnorhavorian, Margarett; van den Heuvel-Eibrink, Marry M.; van Santen, Hanneke M.; Wallace, William H. B.; Green, Daniel M. (2017)
    Treatment with chemotherapy, radiotherapy, or surgery that involves reproductive organs can cause impaired spermatogenesis, testosterone deficiency, and physical sexual dysfunction in male pubertal, adolescent, and young adult cancer survivors. Guidelines for surveillance and management of potential adverse effects could improve cancer survivors' health and quality of life. Surveillance recommendations vary considerably, causing uncertainty about optimum screening practices. This clinical practice guideline recommended by the International Late Effects of Childhood Cancer Guideline Harmonization Group in collaboration with the PanCareSurFup Consortium, developed using evidence-based methodology, critically synthesises surveillance recommendations for gonadotoxicity in male childhood, adolescent, and young adult (CAYA) cancer survivors. The recommendations were developed by an international multidisciplinary panel including 25 experts in relevant medical specialties, using a consistent and transparent process. Recommendations were graded according to the strength of underlying evidence and potential benefit gained by early detection and appropriate management. The aim of the recommendations is to enhance evidence-based care for male CAYA cancer survivors. The guidelines reveal the paucity of high-quality evidence, highlighting the need for further targeted research.
  • Auvray, Marie; Auclin, Edouard; Barthelemy, Philippe; Bono, Petri; Kellokumpu-Lehtinen, Pirkko; Gross-Goupil, Marine; De Velasco, Guillettno; Powles, Thomas; Mouillet, Guillaume; Vano, Yann-Alexandre; Gravis, Gwenaelle; Mourey, Loic; Priou, Franck; Rolland, Frederic; Escudier, Bernard; Albiges, Laurence (2019)
    Background: Nivolumab-ipilimumab demonstrated a survival benefit over sunitinib in first-line setting for metastatic renal cell carcinomas (mRCCs) and is becoming a new standard of care for naive patients with intermediate or poor risk prognosis (International mRCC Database Consortium). The efficacy of subsequent vascular endothelial growth factor receptor tyrosine kinase inhibitors (TKIs) after nivolumab-ipilimumab failure remains unclear. Methods: Medical records of mRCC patients treated with nivolumab-ipilimumab, who received subsequent TKI, as part of Checkmate 214 study were reviewed in 13 institutions. Baseline characteristics, outcome data including progression-free survival (PFS), response, overall survival (OS) and toxicities were retrospectively collected. Results: Overall 33 patients received subsequent TKI after nivolumab-ipilimumab failure. Median follow-up from start of subsequent TKI is 22 months (19-NR). Best response was assessed in 30 patients: 12 partial responses (36%), 13 stable diseases (39%) and five progressive diseases (15%). Median PFS from start of TKI was 8 months [5-13]. Median PFS with first-generation (sunitinib/pazopanib) and second-generation TKI (axitinib/cabozantinib) was 8 months [5-16] and 7 months (5-NA), respectively. PFS in second line was significantly longer in patients with a long first-line duration of response to the double immune checkpoint blockade (>= 6 months) with 8 versus 5 months for short responder (= 3. Conclusion: This is the first report of outcomes with TKI, after first-line nivolumab-ipilimumab failure. Median PFS suggests a sustained benefit of TKI and supports trials investigating the optimal sequence. (C) 2018 Published by Elsevier Ltd.
  • Haider, Malik Salman; Ahmad, Taufiq; Groll, Juergen; Scherf-Clavel, Oliver; Kroiss, Matthias; Luxenhofer, Robert (2021)
    Adrenocortical carcinoma (ACC) is a malignant tumor originating from the adrenal gland cortex with a heterogeneous but overall dismal prognosis in advanced stages. For more than 50 years, mitotane has remained a cornerstone for the treatment of ACC as adjuvant and palliative therapy. It has a very poor aqueous solubility of 0.1 mg/l and high partition coefficient in octanol/water (log P) value of 6. The commercially available dosage form is 500 mg tablets (Lysodren(R)). Even at doses up to 6 g/day (12 tablets in divided doses) for several months, > 50% patients do not achieve therapeutic plasma concentration > 14 mg/l due to poor water solubility, large volume of distribution and inter/intra-individual variability in bioavailability. This article aims to give a concise update of the clinical challenges associated with the administration of high-dose mitotane oral therapy which encompass the issues of poor bioavailability, difficult-to-predict pharmacokinetics and associated adverse events. Moreover, we present recent efforts to improve mitotane formulations. Their success has been limited, and we therefore propose an injectable mitotane formulation instead of oral administration, which could bypass many of the main issues associated with high-dose oral mitotane therapy. A parenteral administration of mitotane could not only help to alleviate the adverse effects but also circumvent the variable oral absorption, give better control over therapeutic plasma mitotane concentration and potentially shorten the time to achieve therapeutic drug plasma concentrations considerably. Plain Language summary Mitotane as tablet form is currently the standard treatment for adrenocortical carcinoma. It has been used for 5 decades but suffers from highly variable responses in patients, subsequent adverse effects and overall lower response rate. This can be fundamentally linked to the exceedingly poor water solubility of mitotane itself. In terms of enhancing water solubility, a few research groups have attempted to develop better formulations of mitotane to overcome the issues associated with tablet dosage form. However, the success rate was limited, and these formulations did not make it into the clinics. In this article, we have comprehensively reviewed the properties of these formulations and discuss the reasons for their limited utility. Furthermore, we discuss a recently developed mitotane nanoformulation that led us to propose a novel approach to mitotane therapy, where intravenous delivery supplements the standard oral administration. With this article, we combine the current state of knowledge as a single piece of information about the various problems associated with the use of mitotane tablets, and herein we postulate the development of a new injectable mitotane formulation, which can potentially circumvent the major problems associated to mitotane's poor water solubility.