Browsing by Subject "guidelines"

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  • 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.
  • Louvanto, Karolina; Eriksson, Tiina; Gray, Penelope; Apter, Dan; Baussano, Iacopo; Bly, Anne; Harjula, Katja; Heikkila, Kaisa; Hokkanen, Mari; Huhtinen, Leila; Ikonen, Marja; Karttunen, Heidi; Nummela, Mervi; Soderlund-Strand, Anna; Veivo, Ulla; Dillner, Joakim; Elfstöm, Miriam; Nieminen, Pekka; Lehtinen, Matti (2020)
    Less frequent cervical cancer screening in human papillomavirus (HPV) vaccinated birth cohorts could produce considerable savings without increasing cervical cancer incidence and loss of life-years. We report here the baseline findings and interim results of safety and accuracy of infrequent screening among HPV16/18 vaccinated females. The entire 1992-1994 birth-cohorts (30,139 females) were invited to a community-randomized HPV16/18-vaccination trial. A total of 9,482 female trial participants received HPV16/18-vaccination in 2007-2009 at age of 13-15. At age 22, 4,273 (45%) of these females consented to attend a randomized trial on frequent (ages 22/25/28; Arm 1: 2,073 females) vs. infrequent screening (age 28; Arm 2: 2,200 females) in 2014-2017. Females (1,329), who had got HPV16/18 vaccination at age 18 comprised the safety Arm 3. Baseline prevalence and incidence of HPV16/18 and other high-risk HPV types were: 0.5% (53/1,000 follow-up years, 10(4)) and 25% (2,530/10(4)) in the frequently screened Arm 1; 0.2% (23/10(4)) and 24% (2,413/10(4)) in the infrequently screened Arm 2; and 3.1% (304/10(4)) and 23% (2,284/10(4)) in the safety Arm 3. Corresponding prevalence of HSIL/ASC-H and of any abnormal cytological findings were: 0.3 and 4.2% (Arm 1), 0.4 and 5.3% (Arm 2) and 0.3 and 4.7% (Arm 3). Equally rare HSIL/CIN3 findings in the infrequently screened safety Arm A3 (0.4%) and in the frequently screened Arm 1 (0.4%) indicate no safety concerns on infrequent screening despite the up to 10 times higher HPV16/18 baseline prevalence and incidence in the former.
  • Thyssen, Jacob P.; Berents, Teresa; Bradley, Maria; Deleuran, Mette; Grimstad, Oystein; Korhonen, Laura; Langeland, Tor; Sarnhult, Tore; Thomsen, Simon Francis; Thune, Turid; Wahlgren, Carl-Fredrik; Vestergaard, Christian; Von Kobyletzki, Laura B.; Remitz, Anita (2020)
    Similarities and differences in the everyday clinical management of moderate-to-severe atopic dermatitis in Nordic countries are unknown. Using a modified Delphi approach, 15 dermatologists from Denmark, Finland, Norway and Sweden completed face-to-face and online questionnaires and participated in summary discussions to map expert opinion on the clinical management of moderate-to-severe atopic dermatitis in these Nordic countries. Through discussions, 6 adult patient profiles, reflecting common disease presentations of atopic dermatitis, were identified. Using these case profiles, diagnostic work-up, treatment goals, patient education and treatment approaches were discussed. Patient education was identified as essential for effective management. A treatment sequence of moderate-to-potent topical glucocorticosteroids and emollients, followed by systemic treatment, was recommended, allowing 3 months to ascertain systemic treatment response before switching, if necessary. Consensus was not reached on systemic treatment choice, reflecting differences in clinical practice and reimbursement between countries. Practical, case-based clinical recommendations were developed for optimal patient care.
  • Agache, Ioana; Akdis, Cezmi; Akdis, Mubeccel; Canonica, Giorgio Walter; Casale, Thomas; Chivato, Tomas; Corren, Jonathan; Chu, Derek K.; Del Giacco, Stefano; Eiwegger, Thomas; Flood, Breda; Firinu, Davide; Gern, James E.; Hamelmann, Eckard; Hanania, Nicola; Hernandez-Martin, Irene; Knibb, Rebeca; Mäkelä, Mika; Nair, Parameswaran; O'Mahony, Liam; Papadopoulos, Nikolaos G.; Papi, Alberto; Park, Hae-Sim; Perez de Llano, Luis; Pfaar, Oliver; Quirce, Santiago; Sastre, Joaquin; Shamji, Mohamed; Schwarze, Jurgen; Palomares, Oscar; Jutel, Marek (2021)
    Severe asthma imposes a significant burden on patients, families and healthcare systems. Management is difficult, due to disease heterogeneity, co-morbidities, complexity in care pathways and differences between national or regional healthcare systems. Better understanding of the mechanisms has enabled a stratified approach to the management of severe asthma, supporting the use of targeted treatments with biologicals. However, there are still many issues that require further clarification. These include selection of a certain biological (as they all target overlapping disease phenotypes), the definition of response, strategies to enhance the responder rate, the duration of treatment and its regimen (in the clinic or home-based) and its cost-effectiveness. The EAACI Guidelines on the use of biologicals in severe asthma follow the GRADE approach in formulating recommendations for each biological and each outcome. In addition, a management algorithm for the use of biologicals in the clinic is proposed, together with future approaches and research priorities.
  • Stacchiotti, S.; Miah, A. B.; Frezza, A. M.; Messiou, C.; Morosi, C.; Caraceni, A.; Antonescu, C. R.; Bajpai, J.; Baldini, E.; Bauer, S.; Biagini, R.; Bielack, S.; Blay, J. Y.; Bonvalot, S.; Boukovinas, I.; Bovee, J. V. M. G.; Boye, K.; Brodowicz, T.; Callegaro, D.; De Alava, E.; Deoras-Sutliff, M.; Dufresne, A.; Eriksson, M.; Errani, C.; Fedenko, A.; Ferraresi, V.; Ferrari, A.; Fletcher, C. D. M.; Del Muro, X. Garcia; Gelderblom, H.; Gladdy, R. A.; Gouin, F.; Grignani, G.; Gutkovich, J.; Haas, R.; Hindi, N.; Hohenberger, P.; Huang, P.; Joensuu, H.; Jones, R. L.; Jungels, C.; Kasper, B.; Kawai, A.; Le Cesne, A.; Le Grange, F.; Leithner, A.; Leonard, H.; Pousa, A. Lopez; Broto, J. Martin; Merimsky, O.; Merriam, P.; Miceli, R.; Mir, O.; Molinari, M.; Montemurro, M.; Oldani, G.; Palmerini, E.; Pantaleo, M. A.; Patel, S.; Piperno-Neumann, S.; Raut, C. P.; Ravi, Arumugam Veera; Razak, A. R. A.; Reichardt, P.; Rubin, B. P.; Rutkowski, P.; Safwat, A. A.; Sangalli, C.; Sapisochin, G.; Sbaraglia, M.; Scheipl, S.; Schoffski, P.; Strauss, D.; Strauss, S. J.; Hall, K. Sundby; Tap, W. D.; Trama, A.; Tweddle, A.; van der Graaf, W. T. A.; Van de Sande, M. A. J.; Van Houdt, W.; van Oortmerssen, G.; Wagner, A. J.; Wartenberg, M.; Wood, J.; Zaffaroni, N.; Zimmermann, C.; Casali, P. G.; Dei Tos, A. P.; Gronchi, A. (2021)
    Epithelioid hemangioendothelioma (EHE) is an ultra-rare, translocated, vascular sarcoma. EHE clinical behavior is variable, ranging from that of a low-grade malignancy to that of a high-grade sarcoma and it is marked by a high propensity for systemic involvement. No active systemic agents are currently approved specifically for EHE, which is typically refractory to the antitumor drugs used in sarcomas. The degree of uncertainty in selecting the most appropriate therapy for EHE patients and the lack of guidelines on the clinical management of the disease make the adoption of new treatments inconsistent across the world, resulting in suboptimal outcomes for many EHE patients. To address the shortcoming, a global consensus meeting was organized in December 2020 under the umbrella of the European Society for Medical Oncology (ESMO) involving >80 experts from several disciplines from Europe, North America and Asia, together with a patient representative from the EHE Group, a global, disease-specific patient advocacy group, and Sarcoma Patient EuroNet (SPAEN). The meeting was aimed at defining, by consensus, evidence-based best practices for the optimal approach to primary and metastatic EHE. The consensus achieved during that meeting is the subject of the present publication.
  • European Stroke Org; Fuentes, Blanca; Ntaios, George; Putaala, Jukka; Thomas, Brenda; Turc, Guillaume; Diez-Tejedor, Exuperio (2018)
    Background Hyperglycaemia is a frequent complication in acute stroke that has been shown to be independently associated with larger infarct size, haematoma growth, poor clinical outcome and mortality. This Guideline Document presents the European Stroke Organisation (ESO) Guidelines for the management of blood glucose levels in patients with acute ischemic or haemorrhagic stroke. Methods The working group identified related questions and developed its recommendations based on evidence from randomised controlled trials following the standard operating procedure of the ESO. This Guideline Document was reviewed and approved by the European Stroke Organisation Guidelines Committee and the European Stroke Organisation Executive Committee. Results We found low-quality evidence from clinical trials in ischemic or haemorrhagic stroke exploring the use of intravenous insulin aimed to achieve a tight glycaemic control with different glucose level targets and several other sources of heterogeneity. None of these trials neither the meta-analysis of them have demonstrated any significant benefit of tight glycaemic control with intravenous insulin in acute ischemic or haemorrhagic stroke patients on functional outcome or in survival and they have shown an increased risk for hypoglycaemia. Conclusions We suggest against the routine use of tight glycaemic control with intravenous insulin as a means to improve outcomes. The currently available data about the management of glycaemia in patients with acute stroke are limited and the strengths of the recommendations are therefore weak. Nevertheless, this does not prevent that hyperglycaemia in acute stroke patients could be treated as any other hospitalised patient.
  • Csonka, Peter; Tapiainen, Terhi; Mäkelä, Mika J.; Lehtimäki, Lauri (2021)
    Aim Our aim was to survey treatment practices used for preschool children with wheezing in emergency rooms (ER) focussing on inhalation device choice and handling, face mask use, salbutamol dosing and written instructions. We sought to assess whether current protocols are in line with published evidence and guidelines. Methods This is a cross-sectional survey done in paediatric ER units located in Finnish municipalities with more than 10 000 inhabitants. Results Of the 100 units contacted, 50% responded. More than 50% of the units used nebulisers. Only 13% of the units administered salbutamol in single puffs. More than 30% of the units lacked criteria on face mask use. Poor co-operation had no effect on the dose of salbutamol in 62% of the units. Ensuring tight mask-to-face seal was included in the training in 20% of the units. A written action plan was provided to the caregivers in 28% of the units. Conclusion ER treatment guidelines for preschool children with wheezing are poorly endorsed. Research is needed to identify approaches to guideline implementation that are specific for primary care. Clinical research should focus on strengthening recommendations that are currently not embraced. ER treatment protocols need to be updated and adherence to guidelines should be re-evaluated.
  • Peck, Michael W.; Smith, Theresa J.; Anniballi, Fabrizio; Austin, John W.; Bano, Luca; Bradshaw, Marite; Cuervo, Paula; Cheng, Luisa W.; Derman, Yagmur; Dorner, Brigitte G.; Fisher, Audrey; Hill, Karen K.; Kalb, Suzanne R.; Korkeala, Hannu; Lindström, Miia; Lista, Florigio; Luquez, Carolina; Mazuet, Christelle; Pirazzini, Marco; Popoff, Michel R.; Rossetto, Ornella; Rummel, Andreas; Sesardic, Dorothea; Singh, Bal Ram; Stringer, Sandra C. (2017)
    Botulinum neurotoxins are diverse proteins. They are currently represented by at least seven serotypes and more than 40 subtypes. New clostridial strains that produce novel neurotoxin variants are being identified with increasing frequency, which presents challenges when organizing the nomenclature surrounding these neurotoxins. Worldwide, researchers are faced with the possibility that toxins having identical sequences may be given different designations or novel toxins having unique sequences may be given the same designations on publication. In order to minimize these problems, an ad hoc committee consisting of over 20 researchers in the field of botulinum neurotoxin research was convened to discuss the clarification of the issues involved in botulinum neurotoxin nomenclature. This publication presents a historical overview of the issues and provides guidelines for botulinum neurotoxin subtype nomenclature in the future.
  • Thery, Clotilde; Witwer, Kenneth W.; Aikawa, Elena; Jose Alcaraz, Maria; Anderson, Johnathon D.; Andriantsitohaina, Ramaroson; Antoniou, Anna; Arab, Tanina; Archer, Fabienne; Atkin-Smith, Georgia K.; Ayre, D. Craig; Bach, Jean-Marie; Bachurski, Daniel; Baharvand, Hossein; Balaj, Leonora; Baldacchino, Shawn; Bauer, Natalie N.; Baxter, Amy A.; Bebawy, Mary; Beckham, Carla; Zavec, Apolonija Bedina; Benmoussa, Abderrahim; Berardi, Anna C.; Bergese, Paolo; Bielska, Ewa; Blenkiron, Cherie; Bobis-Wozowicz, Sylwia; Boilard, Eric; Boireau, Wilfrid; Bongiovanni, Antonella; Borras, Francesc E.; Bosch, Steffi; Boulanger, Chantal M.; Breakefield, Xandra; Breglio, Andrew M.; Brennan, Meadhbh A.; Brigstock, David R.; Brisson, Alain; Broekman, Marike L. D.; Bromberg, Jacqueline F.; Bryl-Gorecka, Paulina; Buch, Shilpa; Buck, Amy H.; Burger, Dylan; Busatto, Sara; Buschmann, Dominik; Bussolati, Benedetta; Buzas, Edit; Byrd, James Bryan; Camussi, Giovanni; Carter, David R. F.; Caruso, Sarah; Chamley, Lawrence W.; Chang, Yu-Ting; Chaudhuri, Amrita Datta; Chen, Chihchen; Chen, Shuai; Cheng, Lesley; Chin, Andrew R.; Clayton, Aled; Clerici, Stefano P.; Cocks, Alex; Cocucci, Emanuele; Coffey, Robert J.; Cordeiro-da-Silva, Anabela; Couch, Yvonne; Coumans, Frank A. W.; Coyle, Beth; Crescitelli, Rossella; Criado, Miria Ferreira; D'Souza-Schorey, Crislyn; Das, Saumya; de Candia, Paola; De Santana Junior, Eliezer F.; De Wever, Olivier; del Portillo, Hernando A.; Demaret, Tanguy; Deville, Sarah; Devitt, Andrew; Dhondt, Bert; Di Vizio, Dolores; Dieterich, Lothar C.; Dolo, Vincenza; Dominguez Rubio, Ana Paula; Dominici, Massimo; Dourado, Mauricio R.; Driedonks, Tom A. P.; Duarte, Filipe; Duncan, Heather M.; Eichenberger, Ramon M.; Ekstrom, Karin; Andaloussi, Samir E. L.; Elie-Caille, Celine; Erdbrugger, Uta; Falcon-Perez, Juan M.; Fatima, Farah; Fish, Jason E.; Flores-Bellver, Miguel; Forsonits, Andras; Frelet-Barrand, Annie; Fricke, Fabia; Fuhrmann, Gregor; Gabrielsson, Susanne; Gamez-Valero, Ana; Gardiner, Chris; Gaertner, Kathrin; Gaudin, Raphael; Gho, Yong Song; Giebel, Bernd; Gilbert, Caroline; Gimona, Mario; Giusti, Ilaria; Goberdhan, Deborah C.; Goergens, Andre; Gorski, Sharon M.; Greening, David W.; Gross, Julia Christina; Gualerzi, Alice; Gupta, Gopal N.; Gustafson, Dakota; Handberg, Aase; Haraszti, Reka A.; Harrison, Paul; Hegyesi, Hargita; Hendrix, An; Hill, Andrew F.; Hochberg, Fred H.; Hoffmann, Karl F.; Holder, Beth; Holthofer, Harry; Hosseinkhani, Baharak; Hu, Guoku; Huang, Yiyao; Huber, Veronica; Hunt, Stuart; Ibrahim, Ahmed Gamal-Eldin; Ikezu, Tsuneya; Inal, Jameel M.; Isin, Mustafa; Ivanova, Alena; Jackson, Hannah K.; Jacobsen, Soren; Jay, Steven M.; Jayachandran, Muthuvel; Jenster, Guido; Jiang, Lanzhou; Johnson, Suzanne M.; Jones, Jennifer C.; Jong, Ambrose; Jovanovic-Talisman, Tijana; Jung, Stephanie; Kalluri, Raghu; Kano, Shin-ichi; Kaur, Sukhbir; Kawamura, Yumi; Keller, Evan T.; Khamari, Delaram; Khomyakova, Elena; Khvorova, Anastasia; Kierulf, Peter; Kim, Kwang Pyo; Kislinger, Thomas; Klingeborn, Mikael; Klinke, David J.; Kornek, Miroslaw; Kosanovic, Maja M.; Kovacs, Arpad Ferenc; Kraemer-Albers, Eva-Maria; Krasemann, Susanne; Krause, Mirja; Kurochkin, Igor; Kusuma, Gina D.; Kuypers, Soren; Laitinen, Saara; Langevin, Scott M.; Languino, Lucia R.; Lannigan, Joanne; Lasser, Cecilia; Laurent, Louise C.; Lavieu, Gregory; Lazaro-Ibanez, Elisa; Le Lay, Soazig; Lee, Myung-Shin; Lee, Yi Xin Fiona; Lemos, Debora S.; Lenassi, Metka; Leszczynska, Aleksandra; Li, Isaac T. S.; Liao, Ke; Libregts, Sten F.; Ligeti, Erzsebet; Lim, Rebecca; Lim, Sai Kiang; Line, Aija; Linnemannstoens, Karen; Llorente, Alicia; Lombard, Catherine A.; Lorenowicz, Magdalena J.; Lorincz, Akos M.; Lotvall, Jan; Lovett, Jason; Lowry, Michelle C.; Loyer, Xavier; Lu, Quan; Lukomska, Barbara; Lunavat, Taral R.; Maas, Sybren L. N.; Malhi, Harmeet; Marcilla, Antonio; Mariani, Jacopo; Mariscal, Javier; Martens-Uzunova, Elena S.; Martin-Jaular, Lorena; Martinez, M. Carmen; Martins, Vilma Regina; Mathieu, Mathilde; Mathivanan, Suresh; Maugeri, Marco; McGinnis, Lynda K.; McVey, Mark J.; Meckes, David G.; Meehan, Katie L.; Mertens, Inge; Minciacchi, Valentina R.; Moller, Andreas; Jorgensen, Malene Moller; Morales-Kastresana, Aizea; Morhayim, Jess; Mullier, Francois; Muraca, Maurizio; Musante, Luca; Mussack, Veronika; Muth, Dillon C.; Myburgh, Kathryn H.; Najrana, Tanbir; Nawaz, Muhammad; Nazarenko, Irina; Nejsum, Peter; Neri, Christian; Neri, Tommaso; Nieuwland, Rienk; Nimrichter, Leonardo; Nolan, John P.; Hoen, Esther N. M. Nolte-'t; Hooten, Nicole Noren; O'Driscoll, Lorraine; O'Grady, Tina; O'Loghlen, Ana; Ochiya, Takahiro; Olivier, Martin; Ortiz, Alberto; Ortiz, Luis A.; Osteikoetxea, Xabier; Ostegaard, Ole; Ostrowski, Matias; Park, Jaesung; Pegtel, D. Michiel; Peinado, Hector; Perut, Francesca; Pfaffl, Michael W.; Phinney, Donald G.; Pieters, Bartijn C. H.; Pink, Ryan C.; Pisetsky, David S.; von Strandmann, Elke Pogge; Polakovicova, Iva; Poon, Ivan K. H.; Powell, Bonita H.; Prada, Ilaria; Pulliam, Lynn; Quesenberry, Peter; Radeghieri, Annalisa; Raffai, Robert L.; Raimondo, Stefania; Rak, Janusz; Ramirez, Marcel; Raposo, Graca; Rayyan, Morsi S.; Regev-Rudzki, Neta; Ricklefs, Franz L.; Robbins, Paul D.; Roberts, David D.; Rodrigues, Silvia C.; Rohde, Eva; Rome, Sophie; Rouschop, Kasper M. A.; Rughetti, Aurelia; Russell, Ashley E.; Saa, Paula; Sahoo, Susmita; Salas-Huenuleo, Edison; Sanchez, Catherine; Saugstad, Julie A.; Saul, Meike J.; Schiffelers, Raymond M.; Schneider, Raphael; Schoyen, Tine Hiorth; Scott, Aaron; Shahaj, Eriomina; Sharma, Shivani; Shatnyeva, Olga; Shekari, Faezeh; Shelke, Ganesh Vilas; Shetty, Ashok K.; Shiba, Kiyotaka; Siljander, Pia R-M; Silva, Andreia M.; Skowronek, Agata; Snyder, Orman L.; Soares, Rodrigo Pedro; Sodar, Barbara W.; Soekmadji, Carolina; Sotillo, Javier; Stahl, Philip D.; Stoorvogel, Willem; Stott, Shannon L.; Strasser, Erwin F.; Swift, Simon; Tahara, Hidetoshi; Tewari, Muneesh; Timms, Kate; Tiwari, Swasti; Tixeira, Rochelle; Tkach, Mercedes; Toh, Wei Seong; Tomasini, Richard; Torrecilhas, Ana Claudia; Pablo Tosar, Juan; Toxavidis, Vasilis; Urbanelli, Lorena; Vader, Pieter; van Balkom, Bas W. M.; van der Grein, Susanne G.; Van Deun, Jan; van Herwijnen, Martijn J. C.; Van Keuren-Jensen, Kendall; van Niel, Guillaume; van Royen, Martin E.; van Wijnen, Andre J.; Helena Vasconcelos, M.; Vechetti, Ivan J.; Veit, Tiago D.; Vella, Laura J.; Velot, Emilie; Verweij, Frederik J.; Vestad, Beate; Vinas, Jose L.; Visnovitz, Tamas; Vukman, Krisztina V.; Wahlgren, Jessica; Watson, Dionysios C.; Wauben, Marca H. M.; Weaver, Alissa; Webber, Jason P.; Weber, Viktoria; Wehman, Ann M.; Weiss, Daniel J.; Welsh, Joshua A.; Wendt, Sebastian; Wheelock, Asa M.; Wiener, Zoltan; Witte, Leonie; Wolfram, Joy; Xagorari, Angeliki; Xander, Patricia; Xu, Jing; Yan, Xiaomei; Yanez-Mo, Maria; Yin, Hang; Yuana, Yuana; Zappulli, Valentina; Zarubova, Jana; Zekas, Vytautas; Zhang, Jian-ye; Zhao, Zezhou; Zheng, Lei; Zheutlin, Alexander R.; Zickler, Antje M.; Zimmermann, Pascale; Zivkovic, Angela M.; Zocco, Davide; Zuba-Surma, Ewa K. (2018)
    The last decade has seen a sharp increase in the number of scientific publications describing physiological and pathological functions of extracellular vesicles (EVs), a collective term covering various subtypes of cell-released, membranous structures, called exosomes, microvesicles, microparticles, ectosomes, oncosomes, apoptotic bodies, and many other names. However, specific issues arise when working with these entities, whose size and amount often make them difficult to obtain as relatively pure preparations, and to characterize properly. The International Society for Extracellular Vesicles (ISEV) proposed Minimal Information for Studies of Extracellular Vesicles ("MISEV") guidelines for the field in 2014. We now update these "MISEV2014" guidelines based on evolution of the collective knowledge in the last four years. An important point to consider is that ascribing a specific function to EVs in general, or to subtypes of EVs, requires reporting of specific information beyond mere description of function in a crude, potentially contaminated, and heterogeneous preparation. For example, claims that exosomes are endowed with exquisite and specific activities remain difficult to support experimentally, given our still limited knowledge of their specific molecular machineries of biogenesis and release, as compared with other biophysically similar EVs. The MISEV2018 guidelines include tables and outlines of suggested protocols and steps to follow to document specific EV-associated functional activities. Finally, a checklist is provided with summaries of key points.
  • Massy, Ziad A.; Caskey, Fergus J.; Finne, Patrik; Harambat, Jerome; Jager, Kitty J.; Nagler, Evi; Stengel, Benedicte; Sever, Mehmet Sukru; Vanholder, Raymond; Blankestijn, Peter J.; Bruchfeld, Annette; Capasso, Giovambattista; Fliser, Danilo; Fouque, Denis; Goumenos, Dimitrios; Soler, Maria Jose; Rychlik, Ivan; Spasovski, Goce; Stevens, Kathryn; Wanner, Christoph; Zoccali, Carmine (2019)
    The strengths and the limitations of research activities currently present in Europe are explored in order to outline how to proceed in the near future. Epidemiological and clinical research and public policy in Europe are generally considered to be comprehensive and successful, and the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) is playing a key role in the field of nephrology research. The Nephrology and Public Policy Committee (NPPC) aims to improve the current situation and translation into public policy by planning eight research topics to be supported in the coming 5 years by ERA-EDTA.
  • Kuula, Joel; Timonen, Hilkka; Niemi, Jarkko V.; Manninen, Hanna E.; Rönkkö, Topi; Hussein, Tareq; Fung, Pak Lun; Tarkoma, Sasu; Laakso, Mikko; Saukko, Erkka; Ovaska, Aino; Kulmala, Markku; Karppinen, Ari; Johansson, Lasse; Petäjä, Tuukka (Copernicus GmbH, 2022)
    Atmospheric Chemistry and Physics
    As evidence of adverse health effects due to air pollution continues to increase, the World Health Organization (WHO) recently published its latest edition of the global air quality guidelines (World Health Organization, 2021). Although not legally binding, the guidelines aim to provide a framework in which policymakers can combat air pollution by formulating evidence-based air quality management strategies. In the light of this, the European Union has stated its intent to revise the current ambient air quality directive (2008/50/EC) to more closely resemble the newly published WHO guidelines (European Commission, 2020). This article provides an informed opinion on selected features of the air quality directive that we believe would benefit from a reassessment. The selected features include discussion about (1) air quality sensors as a part of a hierarchical observation network, (2) the number of minimum sampling points and their siting criteria, and (3) new target air pollution parameters for future consideration.
  • Handal, Marte; Skurtveit, Svetlana; Mahic, Milada; Øhman, Inger; Wikner, Birgitta Norstedt; Tjagvad, Christian; Kieler, Helle; Halmesmäki, Erja; Lund, Ingunn Olea (2020)
    Background: WHO guidelines emphasise the need for descriptions of clinical practice and observational studies on risk and benefits of pharmacotherapies in pregnancy. The aims of the present study were to: (1) Describe opioid maintenance treatment (OMT) in the Scandinavian countries in general, and specifically for pregnant women, (2) Describe a project which utilises a new approach using registry-linkage data to examine associations between prenatal exposure to OMT and child outcomes: a Scandinavian cohort study of pregnant women in OMT during pregnancy (ScopeOMT). Data: Guidelines describing the treatment of persons with opioid use disorders in general, and specifically for pregnant women. Scandinavian registry-linkage data from ScopeOMT. Results: Registry data show that approximately 800 pregnant women received OMT during pregnancy in the period of the ScopeOMT study. Similarities across the Scandinavian countries include access to free healthcare and treatment; multidisciplinary teams trained to support pregnant women in OMT; buprenorphine as the recommended drug when initiating therapy; and a holistic focus on the patients' lives. An important difference is that Norwegian women who use illegal substances that may harm the foetus may be admitted - voluntarily, or against their will - for parts of, or the remainder of the pregnancy to inpatient treatment at specialised clinics. Conclusion: Many similarities in the treatment provided to opioid-dependent persons in the Scandinavian countries place this area in an excellent position to combine the efforts and carry out observational studies concerning the safety of OMT during pregnancy.
  • Pilz, Stefan; Maerz, Winfried; Cashman, Kevin D.; Kiely, Mairead E.; Whiting, Susan J.; Holick, Michael F.; Grant, William B.; Pludowski, Pawel; Hiligsmann, Mickael; Trummer, Christian; Schwetz, Verena; Lerchbaum, Elisabeth; Pandis, Marlene; Tomaschitz, Andreas; Gruebler, Martin R.; Gaksch, Martin; Verheyen, Nicolas; Hollis, Bruce W.; Rejnmark, Lars; Karras, Spyridon N.; Hahn, Andreas; Bischoff-Ferrari, Heike A.; Reichrath, Jörg; Jorde, Rolf; Elmadfa, Ibrahim; Vieth, Reinhold; Scragg, Robert; Calvo, Mona S.; van Schoor, Natasja M.; Bouillon, Roger; Lips, Paul; Itkonen, Suvi T.; Martineau, Adrian R.; Lamberg-Allardt, Christel; Zittermann, Armin (2018)
    Vitamin D deficiency can lead to musculoskeletal diseases such as rickets and osteomalacia, but vitamin D supplementation may also prevent extraskeletal diseases such as respiratory tract infections, asthma exacerbations, pregnancy complications and premature deaths. Vitamin D has a unique metabolism as it is mainly obtained through synthesis in the skin under the influence of sunlight (i.e., ultraviolet-B radiation) whereas intake by nutrition traditionally plays a relatively minor role. Dietary guidelines for vitamin D are based on a consensus that serum 25-hydroxyvitamin D (25[OH]D) concentrations are used to assess vitamin D status, with the recommended target concentrations ranging from >= 25 to >= 50 nmol/L (>= 10->= 20 ng/mL), corresponding to a daily vitamin D intake of 10 to 20 mu g (400-800 international units). Most populations fail to meet these recommended dietary vitamin D requirements. In Europe, 25(OH)D concentrations <30 nmol/L (12 ng/mL) and <50 nmol/L (20 ng/mL) are present in 13.0 and 40.4% of the general population, respectively. This substantial gap between officially recommended dietary reference intakes for vitamin D and the high prevalence of vitamin D deficiency in the general population requires action from health authorities. Promotion of a healthier lifestyle with more outdoor activities and optimal nutrition are definitely warranted but will not erase vitamin D deficiency and must, in the case of sunlight exposure, be well balanced with regard to potential adverse effects such as skin cancer. Intake of vitamin D supplements is limited by relatively poor adherence (in particular in individuals with low-socioeconomic status) and potential for overdosing. Systematic vitamin D food fortification is, however, an effective approach to improve vitamin D status in the general population, and this has already been introduced by countries such as the US, Canada, India, and Finland. Recent advances in our knowledge on the safety of vitamin D treatment, the dose-response relationship of vitamin D intake and 25(OH)D levels, as well as data on the effectiveness of vitamin D fortification in countries such as Finland provide a solid basis to introduce and modify vitamin D food fortification in order to improve public health with this likewise cost-effective approach.
  • Kangasniemi, Mari; Arala, Katariina; Becker, Eve; Suutarla, Anna; Haapa, Toni; Korhonen, Anne (2017)
    Background: Nurses' collegiality is topical because patient care is complicated, requiring shared knowledge and working methods. Nurses' collaboration has been supported by a number of different working models, but there has been less focus on ethics. Aim: This study aimed to develop nurses' collegiality guidelines using the Delphi method. Method: Two online panels of Finnish experts, with 35 and 40 members, used the four-step Delphi method in December 2013 and January 2014. They reformulated the items of nurses' collegiality identified by the literature and rated based on validity and importance. Content analysis and descriptive statistical methods were used to analyze the data, and the nurses' collegiality guidelines were formulated. Ethical considerations: Organizational approval was received, and an informed consent was obtained from all participants. Information about the voluntary nature of participation was provided. Results: During the first Delphi panel round, a number of items were reformulated and added, resulting in 32 reformulated items. As a result of the second round, 8 of the 32 items scored an agreement rate of more than 75%, with the most rated item being collegiality means that professionals respect each other. The item with second highest rating was collegiality has a common objective: what is best for patients, followed by the third highest which was professional ethics is the basis of collegiality. Conclusion: Nurses' collegiality and its content are well recognized in clinical practice but seldom studied. Collegiality can be supported by guidelines, and nurses working in clinical practice, together with teachers and managers, have shared responsibilities to support and develop it. More research in different nursing environments is needed to improve understanding of the content and practice of nursing collegiality.