6,961 results
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2. ESNM/ANMS consensus paper: Diagnosis and management of refractory gastro-esophageal reflux disease.
- Author
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Zerbib F, Bredenoord AJ, Fass R, Kahrilas PJ, Roman S, Savarino E, Sifrim D, Vaezi M, Yadlapati R, and Gyawali CP
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- Eructation diagnosis, Eructation physiopathology, Eructation therapy, Esophageal pH Monitoring methods, Esophageal pH Monitoring standards, Gastroesophageal Reflux physiopathology, Humans, Manometry methods, Manometry standards, Proton Pump Inhibitors therapeutic use, Consensus, Disease Management, Gastroesophageal Reflux diagnosis, Gastroesophageal Reflux therapy, Risk Reduction Behavior
- Abstract
Up to 40% of patients with symptoms suspicious of gastroesophageal reflux disease (GERD) do not respond completely to proton pump inhibitor (PPI) therapy. The term "refractory GERD" has been used loosely in the literature. A distinction should be made between refractory symptoms (ie, symptoms may or may not be GERD-related), refractory GERD symptoms (ie, persisting symptoms in patients with proven GERD, regardless of relationship to ongoing reflux), and refractory GERD (ie, objective evidence of GERD despite adequate medical management). The present ESNM/ANMS consensus paper proposes use the term "refractory GERD symptoms" only in patients with persisting symptoms and previously proven GERD by either endoscopy or esophageal pH monitoring. Even in this context, symptoms may or may not be reflux related. Objective evaluation, including endoscopy and esophageal physiologic testing, is requisite to provide insights into mechanisms of symptom generation and evidence of true refractory GERD. Some patients may have true ongoing refractory acid or weakly acidic reflux despite PPIs, while others have no evidence of ongoing reflux, and yet others have functional esophageal disorders (overlapping with proven GERD confirmed off therapy). In this context, attention should also be paid to supragastric belching and rumination syndrome, which may be important contributors to refractory symptoms., (© 2020 John Wiley & Sons Ltd.)
- Published
- 2021
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3. Clinical management of patients with genetic obesity during COVID-19 pandemic: position paper of the ESE Growth & Genetic Obesity COVID-19 Study Group and Rare Endo-ERN main thematic group on Growth and Obesity.
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De Groot CJ, Poitou Bernert C, Coupaye M, Clement K, Paschou SA, Charmandari E, Kanaka-Gantenbein C, Wabitsch M, Buddingh EP, Nieuwenhuijsen B, Marina L, Johannsson G, and Van Den Akker ELT
- Subjects
- Anxiety, Healthy Lifestyle, Humans, Obesity epidemiology, Obesity genetics, COVID-19, Disease Management, Obesity therapy, Pandemics
- Abstract
This article aims to provide guidance on prevention and treatment of COVID-19 in patients with genetic obesity. Key principals of the management of patients with genetic obesity during COVID-19 pandemic for patients that have contracted COVID-19 are to be aware of: possible adrenal insufficiency (e.g., POMC deficiency, PWS); a more severe course in patients with concomitant immunodeficiency (e.g., LEP and LEPR deficiency), although defective leptin signalling could also be protective against the pro-inflammatory phenotype of COVID-19; disease severity being masked by insufficient awareness of symptoms in syndromic obesity patients with intellectual deficit (in particular PWS); to adjust medication dose to increased body size, preferably use dosing in m2; the high risk of malnutrition in patients with Sars-Cov2 infection, even in case of obesity. Key principals of the obesity management during the pandemic are to strive for optimal obesity management and a healthy lifestyle within the possibilities of the regulations to prevent weight (re)gain and to address anxiety within consultations, since prevalence of anxiety for COVID-19 is underestimated.
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- 2021
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4. Management of heart failure patients with COVID-19: a joint position paper of the Chinese Heart Failure Association & National Heart Failure Committee and the Heart Failure Association of the European Society of Cardiology.
- Author
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Zhang Y, Coats AJS, Zheng Z, Adamo M, Ambrosio G, Anker SD, Butler J, Xu D, Mao J, Khan MS, Bai L, Mebazaa A, Ponikowski P, Tang Q, Ruschitzka F, Seferovic P, Tschöpe C, Zhang S, Gao C, Zhou S, Senni M, Zhang J, and Metra M
- Subjects
- COVID-19, China, Comorbidity, Coronavirus Infections therapy, Europe, Heart Failure epidemiology, Humans, Pneumonia, Viral therapy, SARS-CoV-2, Betacoronavirus, Cardiology, Coronavirus Infections epidemiology, Disease Management, Heart Failure therapy, Pandemics, Pneumonia, Viral epidemiology, Societies, Medical
- Abstract
The coronavirus disease 2019 (COVID-19) pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is causing considerable morbidity and mortality worldwide. Multiple reports have suggested that patients with heart failure (HF) are at a higher risk of severe disease and mortality with COVID-19. Moreover, evaluating and treating HF patients with comorbid COVID-19 represents a formidable clinical challenge as symptoms of both conditions may overlap and they may potentiate each other. Limited data exist regarding comprehensive management of HF patients with concomitant COVID-19. Since these issues pose serious new challenges for clinicians worldwide, HF specialists must develop a structured approach to the care of patients with COVID-19 and be included early in the care of these patients. Therefore, the Heart Failure Association of the European Society of Cardiology and the Chinese Heart Failure Association & National Heart Failure Committee conducted web-based meetings to discuss these unique clinical challenges and reach a consensus opinion to help providers worldwide deliver better patient care. The main objective of this position paper is to outline the management of HF patients with concomitant COVID-19 based on the available data and personal experiences of physicians from Asia, Europe and the United States., (© 2020 European Society of Cardiology.)
- Published
- 2020
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5. Management of status epilepticus in adults. Position paper of the Italian League against Epilepsy.
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Minicucci F, Ferlisi M, Brigo F, Mecarelli O, Meletti S, Aguglia U, Michelucci R, Mastrangelo M, Specchio N, Sartori S, and Tinuper P
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- Adult, Anticonvulsants therapeutic use, Epilepsy epidemiology, Humans, Italy epidemiology, Neurosurgical Procedures methods, Neurosurgical Procedures standards, Randomized Controlled Trials as Topic methods, Status Epilepticus epidemiology, Disease Management, Epilepsy therapy, Randomized Controlled Trials as Topic standards, Status Epilepticus therapy
- Abstract
Since the publication of the Italian League Against Epilepsy guidelines for the treatment of status epilepticus in 2006, advances in the field have ushered in improvements in the therapeutic arsenal. The present position paper provides neurologists, epileptologists, neurointensive care specialists, and emergency physicians with updated recommendations for the treatment of adult patients with status epilepticus. The aim is to standardize treatment recommendations in the care of this patient population., (Copyright © 2019 Elsevier Inc. All rights reserved.)
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- 2020
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6. Management of pulmonary ground-glass opacities: a position paper from a panel of experts of the Italian Society of Thoracic Surgery (SICT).
- Author
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Lococo F, Luzzi L, Cusumano G, De Filippis AF, Pariscenti G, Guggino G, Rena O, Davini F, Grossi W, Marulli G, Lococo A, and Cardillo G
- Subjects
- Humans, Italy, Consensus, Disease Management, Lung Neoplasms surgery, Societies, Medical, Thoracic Surgery, Thoracic Surgical Procedures methods
- Abstract
Objectives: A significant gap in our knowledge of how to manage pulmonary ground-glass opacities (GGOs) still exists. Accordingly, there is a lack of consensus among clinicians on this topic. The Italian Society of Thoracic Surgery (Società Italiana di Chirurgia Toracica, SICT) promoted a national expert meeting to provide insightful guidance for clinical practice. Our goal was to publish herein the final consensus document from this conference., Methods: The working panel of the PNR group (Pulmonary Nodules Recommendation Group, a branch of the SICT) together with 5 scientific supervisors (nominated by the SICT) identified a jury of expert thoracic surgeons who organized a multidisciplinary meeting to propose specific statements (n = 29); 73 participants discussed and voted on statements using a modified Delphi process (repeated iterations of anonymous voting over 2 rounds with electronic support) requiring 70% agreement to reach consensus on a statement., Results: Consensus was reached on several critical points in GGO management, in particular on the definition of GGO, radiological and radiometabolic evaluation, indications for a non-surgical biopsy, GGO management based on radiological characteristics, surgical strategies (extension of pulmonary resection and lymphadenectomy) and radiological surveillance. A list of 29 statements was finally approved., Conclusions: The participants at this national expert meeting analysed this challenging topic and provided a list of suggestions for health institutions and physicians with practical indications for GGO management., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2020
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7. Systematic review of the screening, diagnosis, and management of ADHD in children with epilepsy. Consensus paper of the Task Force on Comorbidities of the ILAE Pediatric Commission.
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Auvin S, Wirrell E, Donald KA, Berl M, Hartmann H, Valente KD, Van Bogaert P, Cross JH, Osawa M, Kanemura H, Aihara M, Guerreiro MM, Samia P, Vinayan KP, Smith ML, Carmant L, Kerr M, Hermann B, Dunn D, and Wilmshurst JM
- Subjects
- Anticonvulsants therapeutic use, Central Nervous System Stimulants therapeutic use, Humans, Attention Deficit Disorder with Hyperactivity complications, Attention Deficit Disorder with Hyperactivity diagnosis, Attention Deficit Disorder with Hyperactivity epidemiology, Attention Deficit Disorder with Hyperactivity therapy, Disease Management, Epilepsy complications, Epilepsy diagnosis, Epilepsy epidemiology, Epilepsy therapy
- Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common and challenging comorbidity affecting many children with epilepsy. A working group under the International League Against Epilepsy (ILAE) Pediatric Commission identified key questions on the identification and management of ADHD in children with epilepsy. Systematic reviews of the evidence to support approaches to these questions were collated and graded using criteria from the American Academy of Neurology Practice Parameter. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) requirements were followed, with PROSPERO registration (CRD42018094617). No increased risk of ADHD in boys with epilepsy compared to girls with epilepsy was found (Level A). Valproate use in pregnancy is associated with inattentiveness and hyperactivity in offspring (1 class I study), and children with intellectual and developmental disabilities are at increased risk of ADHD (Level A). Impact of early seizure onset on development of ADHD was unclear (Level U), but more evident with poor seizure control (Level B). ADHD screening should be performed from 6 years of age, or at diagnosis, and repeated annually (Level U) and reevaluated after change of antiepileptic drug (AED) (Level U). Diagnosis should involve health practitioners with expert training in ADHD (Level U). Use of the Strength and Difficulties Questionnaire screening tool is supported (Level B). Formal cognitive testing is strongly recommended in children with epilepsy who are struggling at school (Level U). Behavioral problems are more likely with polytherapy than monotherapy (Level C). Valproate can exacerbate attentional issues in children with childhood absence epilepsy (Level A). Methylphenidate is tolerated and effective in children with epilepsy (Level B). Limited evidence supports that atomoxetine is tolerated (Level C). Multidisciplinary involvement in transition and adult ADHD clinics is essential (Level U). In conclusion, although recommendations could be proposed for some of the study questions, this systematic review highlighted the need for more comprehensive and targeted large-population prospective studies., (Wiley Periodicals, Inc. © 2018 International League Against Epilepsy.)
- Published
- 2018
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8. Italian position paper (SIPMO‐SICMF) on medication‐related osteonecrosis of the jaw (MRONJ).
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Bedogni, Alberto, Mauceri, Rodolfo, Fusco, Vittorio, Bertoldo, Francesco, Bettini, Giordana, Di Fede, Olga, Lo Casto, Antonio, Marchetti, Claudio, Panzarella, Vera, Saia, Giorgia, Vescovi, Paolo, and Campisi, Giuseppina
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JAW diseases , *RISK assessment , *DIPHOSPHONATES , *DISEASE management , *STRUCTURED treatment interruption , *TUMOR classification , *OSTEONECROSIS , *DISEASE risk factors - Abstract
Objective: This paper aims to describe the 2023 update position paper on MRONJ developed by the Italian Societies of Oral Pathology and Medicine (SIPMO) and of Maxillofacial Surgery (SICMF). Methods: This is the second update following the 2013 and 2020 Italian position papers by the Expert panel, which is a representation of the two scientific societies (SIPMO and SICMF). The paper is based on an extensive analysis of the available literature from January 2003 to February 2020, and the subsequent review of literature conducted between March 2020 and December 2022 to include all new relevant published papers to confirm or modify the previous set of recommendations. Results: This position paper highlights the main issues of MRONJ on risk estimates, disease definition, diagnostic pathway, individual risk assessment, and the fundamental role of imaging in the diagnosis, classification, and management of MRONJ. Conclusion: The Expert Panel confirmed the MRONJ definition, the diagnostic work‐up, the clinical‐radiological staging system and the prophylactic drug holiday, as recognized by SIPMO‐SICMF; while, it presented novel indications regarding the categories at risk of MRONJ, the prevention strategies, and the treatment strategies associated with the therapeutic drug holiday. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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9. Assessment and treatment of nonsurgical thumb carpometacarpal joint osteoarthritis: A modified Delphi-based consensus paper of the American Society of Hand Therapists.
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Algar, Lori, Naughton, Nancy, Ivy, Cynthia, Loomis, Katherine, McGee, Corey, Strouse, Stephanie, and Fedorczyk, Jane
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ALLIED health associations ,OSTEOARTHRITIS treatment ,CONSENSUS (Social sciences) ,THERAPEUTICS ,HAND injury treatment ,ATTITUDE (Psychology) ,HEALTH outcome assessment ,SURVEYS ,TREATMENT effectiveness ,DESCRIPTIVE statistics ,PATIENT education ,CARPOMETACARPAL joints ,DISEASE management ,DELPHI method ,WORLD Wide Web - Abstract
While the literature is abundant on hand therapy assessment and treatment of nonsurgical thumb carpometacarpal (CMC) osteoarthritis (OA), clarity and uniformity are meager, making it a desirable diagnosis to establish expert consensus. This study aimed to ascertain if consensus exists for the assessment and treatment of nonsurgical management of thumb CMC OA in the hand therapy clinical setting. This was a consensus paper via the modified Delphi approach. A modified Delphi method was used to determine consensus among an expert panel, including hand therapists and hand surgeons, via two online surveys. A consensus paper steering committee (from the American Society of Hand Therapist's research division) designed the surveys and analyzed responses. Consensus was established as 75% agreement among the expert panel. Demographic information was collected from the expert panel. The expert panel included 34 hand therapists and seven hand surgeons. The survey response rates were 93.6% for the first survey and 90.2% for the second survey. Consensus recommendations were classified according to the World Health Organization categorization. These included evaluating the body structures for clinical signs/clinical testing and body functions for pain, range of motion for palmar abduction, radial abduction, opposition, and thumb metacarpal phalangeal flexion/extension, and grip and tripod pinch strength. Further consensus recommendations were for the assessment of function using a region-specific, upper extremity patient-reported outcome measure (activity and participation), environmental factors, outcome expectation, and illness perception within the patient's unique environmental and social contexts. Treatment recommendations included the use of an orthosis during painful activities, a dynamic stability program (stable C posture, release of tight adductors, and strengthening of stabilizers), patient education, joint protection techniques, adaptive equipment, and functional-based intervention. The findings describe the consensus of a group of experts and provide a clinical reference tool on the hand therapy assessment and treatment of nonsurgical thumb CMC joint OA. • A consensus paper using a modified Delphi process to determine consensus on non-surgical assessment and treatment of thumb CMC OA. • Assessment recommendations: evaluate clinical signs/testing, pain, thumb range of motion grip and tripod pinch, a region-specific PROM, environmental factors, outcome expectation, and illness perception. • Treatment: orthosis during painful activities as needed, a dynamic stability program, patient education, joint protection techniques, adaptive equipment, and functional based intervention. • Findings provide a clinical reference tool on hand therapy assessment and treatment of non-surgical CMC joint OA. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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10. Quantitative reagent monitoring in paper-based electrochemical rapid diagnostic tests.
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Bezinge, Léonard, deMello, Andrew J., Shih, Chih-Jen, and Richards, Daniel A.
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RAPID diagnostic tests , *POINT-of-care testing , *DISEASE management , *COMMUNICABLE diseases , *BIOELECTROCHEMISTRY - Abstract
Paper-based rapid diagnostic tests (RDTs) are an essential component of modern healthcare, particularly for the management of infectious diseases. Despite their utility, these capillary-driven RDTs are compromised by high failure rates, primarily caused by user error. This limits their utility in complex assays that require multiple user operations. Here, we demonstrate how this issue can be directly addressed through continuous electrochemical monitoring of reagent flow inside an RDT using embedded graphenized electrodes. Our method relies on applying short voltage pulses and measuring variations in capacitive discharge currents to precisely determine the flow times of injected samples and reagents. This information is reported to the user, guiding them through the testing process, highlighting failure cases and ultimately decreasing errors. Significantly, the same electrodes can be used to quantify electrochemical signals from immunoassays, providing an integrated solution for both monitoring assays and reporting results. We demonstrate the applicability of this approach in a serology test for the detection of anti-SARS-CoV-2 IgG in clinical serum samples. This method paves the way towards "smart" RDTs able to continuously monitor the testing process and improve the robustness of point-of-care diagnostics. [ABSTRACT FROM AUTHOR]
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- 2024
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11. Long-term prognosis, subsequent pregnancy, contraception and overall management of peripartum cardiomyopathy: practical guidance paper from the Heart Failure Association of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy.
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Sliwa K, Petrie MC, Hilfiker-Kleiner D, Mebazaa A, Jackson A, Johnson MR, van der Meer P, Mbakwem A, and Bauersachs J
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- Contraception, Europe, Female, Forecasting, Humans, Morbidity trends, Pregnancy, Cardiology, Cardiomyopathies complications, Cardiomyopathies physiopathology, Cardiomyopathies therapy, Disease Management, Heart Failure epidemiology, Heart Failure etiology, Heart Failure prevention & control, Peripartum Period, Practice Guidelines as Topic, Societies, Medical
- Abstract
Peripartum cardiomyopathy is an idiopathic cardiomyopathy presenting with heart failure secondary to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause for heart failure is identified. Outcome varies from full recovery to residual left ventricular systolic dysfunction and even death. Many women return to their physician to acquire information on their long-term prognosis, to seek medical advice regarding contraception, or when planning a subsequent pregnancy. This position paper summarizes current evidence for long-term outcome, risk stratification of further pregnancies and overall management. Based on the best available evidence, as well as the clinical experience of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy members, a consensus on pre- and postpartum management algorithms for women undergoing a subsequent pregnancy is presented., (© 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology.)
- Published
- 2018
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12. Editor's Choice - Acute Cardiovascular Care Association Position Paper on Intensive Cardiovascular Care Units: An update on their definition, structure, organisation and function.
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Bonnefoy-Cudraz E, Bueno H, Casella G, De Maria E, Fitzsimons D, Halvorsen S, Hassager C, Iakobishvili Z, Magdy A, Marandi T, Mimoso J, Parkhomenko A, Price S, Rokyta R, Roubille F, Serpytis P, Shimony A, Stepinska J, Tint D, Trendafilova E, Tubaro M, Vrints C, Walker D, Zahger D, Zima E, Zukermann R, and Lettino M
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- Acute Disease, Europe, Humans, Cardiology, Cardiovascular Diseases therapy, Coronary Care Units organization & administration, Critical Care organization & administration, Disease Management, Periodicals as Topic, Societies, Medical
- Abstract
Acute cardiovascular care has progressed considerably since the last position paper was published 10 years ago. It is now a well-defined, complex field with demanding multidisciplinary teamworking. The Acute Cardiovascular Care Association has provided this update of the 2005 position paper on acute cardiovascular care organisation, using a multinational working group. The patient population has changed, and intensive cardiovascular care units now manage a large range of conditions from those simply requiring specialised monitoring, to critical cardiovascular diseases with associated multi-organ failure. To describe better intensive cardiovascular care units case mix, acuity of care has been divided into three levels, and then defining intensive cardiovascular care unit functional organisation. For each level of intensive cardiovascular care unit, this document presents the aims of the units, the recommended management structure, the optimal number of staff, the need for specially trained cardiologists and cardiovascular nurses, the desired equipment and architecture, and the interaction with other departments in the hospital and other intensive cardiovascular care units in the region/area. This update emphasises cardiologist training, referring to the recently updated Acute Cardiovascular Care Association core curriculum on acute cardiovascular care. The training of nurses in acute cardiovascular care is additionally addressed. Intensive cardiovascular care unit expertise is not limited to within the unit's geographical boundaries, extending to different specialties and subspecialties of cardiology and other specialties in order to optimally manage the wide scope of acute cardiovascular conditions in frequently highly complex patients. This position paper therefore addresses the need for the inclusion of acute cardiac care and intensive cardiovascular care units within a hospital network, linking university medical centres, large community hospitals, and smaller hospitals with more limited capabilities.
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- 2018
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13. White Paper AGA: POWER - Practice Guide on Obesity and Weight Management, Education, and Resources.
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Acosta A, Streett S, Kroh MD, Cheskin LJ, Saunders KH, Kurian M, Schofield M, Barlow SE, and Aronne L
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- Humans, Societies, Scientific, United States, Disease Management, Obesity diagnosis, Obesity therapy
- Abstract
The epidemic of obesity continues at alarming rates, with a high burden to our economy and society. The American Gastroenterological Association understands the importance of embracing obesity as a chronic, relapsing disease and supports a multidisciplinary approach to the management of obesity. Because gastrointestinal disorders resulting from obesity are more frequent and often present sooner than type 2 diabetes mellitus and cardiovascular disease, gastroenterologists have an opportunity to address obesity and provide an effective therapy early. Patients who are overweight or obese already fill gastroenterology clinics with gastroesophageal reflux disease and its associated risks of Barrett's esophagus and esophageal cancer, gallstone disease, nonalcoholic fatty liver disease/nonalcoholic steatohepatitis, and colon cancer. Obesity is a major modifiable cause of diseases of the digestive tract that frequently goes unaddressed. As internists, specialists in digestive disorders, and endoscopists, gastroenterologists are in a unique position to play an important role in the multidisciplinary treatment of obesity. This American Gastroenterological Association paper was developed with content contribution from Society of American Gastrointestinal and Endoscopic Surgeons, The Obesity Society, Academy of Nutrition and Dietetics, and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, endorsed with input by American Society for Gastrointestinal Endoscopy, American Society for Metabolic and Bariatric Surgery, American Association for the Study of Liver Diseases, and Obesity Medicine Association, and describes POWER: Practice Guide on Obesity and Weight Management, Education and Resources. Its objective is to provide physicians with a comprehensive, multidisciplinary process to guide and personalize innovative obesity care for safe and effective weight management., (Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
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14. Position paper for management of elderly patients with pacemakers and implantable cardiac defibrillators: Groupe de Rythmologie et Stimulation Cardiaque de la Société Française de Cardiologie and Société Française de Gériatrie et Gérontologie.
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Fauchier L, Alonso C, Anselme F, Blangy H, Bordachar P, Boveda S, Clementy N, Defaye P, Deharo JC, Friocourt P, Gras D, Halimi F, Klug D, Mansourati J, Obadia B, Pasquié JL, Pavin D, Sadoul N, Taieb J, Piot O, and Hanon O
- Subjects
- Aged, France, Humans, Societies, Medical, Arrhythmias, Cardiac therapy, Cardiac Resynchronization Therapy standards, Cardiology standards, Defibrillators, Implantable, Disease Management, Heart Failure therapy, Pacemaker, Artificial
- Abstract
Despite the increasingly high rate of implantation of pacemakers (PMs) and implantable cardioverter defibrillators (ICDs) in elderly patients, data supporting their clinical and cost-effectiveness in this age stratum are ambiguous and contradictory. We reviewed the data regarding the applicability, safety and effectiveness of conventional pacing, ICDs and cardiac resynchronization therapy (CRT) in elderly patients. Although periprocedural risk may be slightly higher in the elderly, the implantation procedure for PMs and ICDs is still relatively safe in this age group. In older patients with sinus node disease, the general consensus is that DDD pacing with the programming of an algorithm to minimize ventricular pacing is preferred. In very old patients presenting with intermittent or suspected atrioventricular block, VVI pacing may be appropriate. In terms of correcting potentially life-threatening arrhythmias, the effectiveness of ICD therapy is similar in older and younger individuals. However, the assumption of persistent ICD benefit in the elderly population is questionable, as any advantageous effect of the device on arrhythmic death may be attenuated by higher total non-arrhythmic mortality. While septuagenarians and octogenarians have higher annual all-cause mortality rates, ICD therapy may remain effective in selected patients at high risk of arrhythmic death and with minimum comorbidities despite advanced age. ICD implantation among the elderly, as a group, may not be cost-effective, but the procedure may reach cost-effectiveness in those expected to live more than 5-7years after implantation. Elderly patients usually experience significant functional improvement after CRT, similar to that observed in middle-aged patients. Management of CRT non-responders remains globally the same, while considering a less aggressive approach in terms of reinterventions (revision of left ventricular [LV] lead placement, addition of a right ventricular or LV lead, LV endocardial pacing configuration). Overall, physiological age, general status and comorbidities rather than chronological age per se should be the decisive factors in making a decision about device implantation selection for survival and well-being benefit in elderly patients., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)
- Published
- 2016
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15. Sarcopenia: A Time for Action. An SCWD Position Paper
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Bauer, Juergen, Morley, John E, Schols, Annemie MWJ, Ferrucci, Luigi, Cruz‐Jentoft, Alfonso J, Dent, Elsa, Baracos, Vickie E, Crawford, Jeffrey A, Doehner, Wolfram, Heymsfield, Steven B, Jatoi, Aminah, Kalantar‐Zadeh, Kamyar, Lainscak, Mitja, Landi, Francesco, Laviano, Alessandro, Mancuso, Michelangelo, Muscaritoli, Maurizio, Prado, Carla M, Strasser, Florian, Haehling, Stephan, Coats, Andrew JS, and Anker, Stefan D
- Subjects
Nutrition ,Biomedical Imaging ,Prevention ,Aging ,Musculoskeletal ,Disease Management ,Disease Susceptibility ,Humans ,Practice Guidelines as Topic ,Sarcopenia ,Cachexia ,Geriatric assessment ,Muscle ,Skeletal ,Muscle strength ,Physiology ,Clinical Sciences ,Human Movement and Sports Sciences - Abstract
The term sarcopenia was introduced in 1988. The original definition was a "muscle loss" of the appendicular muscle mass in the older people as measured by dual energy x-ray absorptiometry (DXA). In 2010, the definition was altered to be low muscle mass together with low muscle function and this was agreed upon as reported in a number of consensus papers. The Society of Sarcopenia, Cachexia and Wasting Disorders supports the recommendations of more recent consensus conferences, i.e. that rapid screening, such as with the SARC-F questionnaire, should be utilized with a formal diagnosis being made by measuring grip strength or chair stand together with DXA estimation of appendicular muscle mass (indexed for height2). Assessments of the utility of ultrasound and creatine dilution techniques are ongoing. Use of ultrasound may not be easily reproducible. Primary sarcopenia is aging associated (mediated) loss of muscle mass. Secondary sarcopenia (or disease-related sarcopenia) has predominantly focused on loss of muscle mass without the emphasis on muscle function. Diseases that can cause muscle wasting (i.e. secondary sarcopenia) include malignant cancer, COPD, heart failure, and renal failure and others. Management of sarcopenia should consist of resistance exercise in combination with a protein intake of 1 to 1.5 g/kg/day. There is insufficient evidence that vitamin D and anabolic steroids are beneficial. These recommendations apply to both primary (age-related) sarcopenia and secondary (disease related) sarcopenia. Secondary sarcopenia also needs appropriate treatment of the underlying disease. It is important that primary care health professionals become aware of and make the diagnosis of age-related and disease-related sarcopenia. It is important to address the risk factors for sarcopenia, particularly low physical activity and sedentary behavior in the general population, using a life-long approach. There is a need for more clinical research into the appropriate measurement for muscle mass and the management of sarcopenia. Accordingly, this position statement provides recommendations on the management of sarcopenia and how to progress the knowledge and recognition of sarcopenia.
- Published
- 2019
16. A recommended practical approach to the management of anthracycline-based chemotherapy cardiotoxicity: an opinion paper of the working group on drug cardiotoxicity and cardioprotection, Italian Society of Cardiology.
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Spallarossa P, Maurea N, Cadeddu C, Madonna R, Mele D, Monte I, Novo G, Pagliaro P, Pepe A, Tocchetti CG, Zito C, and Mercuro G
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- Cardiologists education, Cardiotoxicity prevention & control, Cardiovascular Diseases physiopathology, Humans, Italy, Neoplasms drug therapy, Risk Assessment, Societies, Medical, Antineoplastic Agents adverse effects, Cardiovascular Diseases chemically induced, Cardiovascular Diseases prevention & control, Disease Management
- Abstract
Anthracyclines are the mainstay of treatment of a variety of haematological malignancies and solid tumours. Unfortunately, the clinical use of these drugs is limited by cumulative, dose-related cardiotoxicity which may ultimately lead to a severe and irreversible form of cardiomyopathy. Thus, there is an increasing need for close cooperation among cardiologists, oncologists and haemato-oncologists. As anthracyclines save lives, the logical goal of this cooperation, besides preventing or mitigating cardiotoxicity, is to promote an acceptable balance between the potential cardiac side effects and the vital benefit of anticancer treatment. This manuscript, which is specifically addressed to the cardiologist who has not accumulated much experience in the field of cancer therapy, focuses on several topics, that is old and new mechanisms of cardiac toxicity, late cardiac toxicity, the importance of overall risk assessment, the key role of a cardiology consult before starting cancer therapy, and the pros and cons of primary and secondary prevention programmes.
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- 2016
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17. A recommended practical approach to the management of target therapy and angiogenesis inhibitors cardiotoxicity: an opinion paper of the working group on drug cardiotoxicity and cardioprotection, Italian Society of Cardiology.
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Maurea N, Spallarossa P, Cadeddu C, Madonna R, Mele D, Monte I, Novo G, Pagliaro P, Pepe A, Tocchetti CG, Zito C, and Mercuro G
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- Cardiology, Cardiomyopathies chemically induced, Cardiotoxicity drug therapy, Heart Failure chemically induced, Humans, Italy, Practice Guidelines as Topic, Societies, Medical, Ventricular Dysfunction, Left chemically induced, Angiogenesis Inhibitors adverse effects, Antineoplastic Agents adverse effects, Cardiotoxicity diagnostic imaging, Disease Management, Neoplasms drug therapy
- Abstract
The US National Cancer Institute estimates that cardiotoxicity (CTX) from target therapy refers mostly to four groups of drugs: epidermal growth factor receptor 2 inhibitors, angiogenic inhibitors, directed Abelson murine leukemia viral oncogene homolog inhibitors, and proteasome inhibitors. The main cardiotoxic side-effects related to antiepidermal growth factor receptor 2 therapy are left ventricular systolic dysfunction and heart failure. Angiogenesis inhibitors are associated with hypertension, left ventricular dysfunction/heart failure, myocardial ischemia, QT prolongation, and thrombosis. Moreover, other agents may be related to CTX induced by treatment. In this study, we review the guidelines for a practical approach for the management of CTX in patients under anticancer target therapy.
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- 2016
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18. Long-Term Condition Self-Management Support in Online Communities: A Meta-Synthesis of Qualitative Papers.
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Allen C, Vassilev I, Kennedy A, and Rogers A
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- Emotions, Humans, Narration, Self-Help Groups, Chronic Disease therapy, Disease Management, Internet, Peer Group, Self Care, Social Support
- Abstract
Background: Recent years have seen an exponential increase in people with long-term conditions using the Internet for information and support. Prior research has examined support for long-term condition self-management through the provision of illness, everyday, and emotional work in the context of traditional offline communities. However, less is known about how communities hosted in digital spaces contribute through the creation of social ties and the mobilization of an online illness "workforce.", Objective: The aim was to understand the negotiation of long-term condition illness work in patient online communities and how such work may assist the self-management of long-term conditions in daily life., Methods: A systematic search of qualitative papers was undertaken using various online databases for articles published since 2004. A total of 21 papers met the inclusion criteria of using qualitative methods and examined the use of peer-led online communities for those with a long-term condition. A qualitative meta-synthesis was undertaken and the review followed a line of argument synthesis., Results: The main themes identified in relation to the negotiation of self-management support were (1) redressing offline experiential information and knowledge deficits, (2) the influence of modeling and learning behaviors from others on self-management, (3) engagement that validates illness and negates offline frustrations, (4) tie formation and community building, (5) narrative expression and cathartic release, and (6) dissociative anonymity and invisibility. These translated into a line of argument synthesis in which four network mechanisms for self-management support in patient online communities were identified. These were (1) collective knowledge and identification through lived experience; (2) support, information, and engagement through readily accessible gifting relationships; (3) sociability that extends beyond illness; and (4) online disinhibition as a facilitator in the negotiation of self-management support., Conclusions: Social ties forged in online spaces provide the basis for performing relevant self-management work that can improve an individual's illness experience, tackling aspects of self-management that are particularly difficult to meet offline. Membership in online groups can provide those living with a long-term condition with ready access to a self-management support illness workforce and illness and emotional support. The substitutability of offline illness work may be particularly important to those whose access to support offline is either limited or absent. Furthermore, such resources require little negotiation online because information and support is seemingly gifted to the community by its members.
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- 2016
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19. Contributions of Peer Support to Health, Health Care, and Prevention: Papers from Peers for Progress.
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Fisher EB, Ayala GX, Ibarra L, Cherrington AL, Elder JP, Tang TS, Heisler M, Safford MM, and Simmons D
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- China, Counseling methods, Humans, Self Care, Chronic Disease psychology, Disease Management, Peer Group, Social Support
- Abstract
SUBSTANTIAL: evidence documents the benefits of peer support provided by community health workers, lay health advisors, promotores de salud, and others. The papers in this supplement, all supported by the Peers for Progress program of the American Academy of Family Physicians Foundation, contribute to the growing body of literature addressing the efficacy, effectiveness, feasibility, reach, sustainability, and adoption of peer support for diabetes self-management. They and additional papers supported by Peers for Progress contribute to understanding how peer support can be implemented in real world settings. Topics include examination of the peers who provide peer support, reaching the hardly reached, success factors in peer support interventions, proactive approaches, attention to emotions, peer support in behavioral health, dissemination models and their application in China, peer support in the patient-centered medical home, research challenges, and policy implications., (© 2015 Annals of Family Medicine, Inc.)
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- 2015
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20. Diagnosis and management of asthma in preschoolers: A Canadian Thoracic Society and Canadian Paediatric Society position paper.
- Author
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Ducharme FM, Dell SD, Radhakrishnan D, Grad RM, Watson WT, Yang CL, and Zelman M
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- Algorithms, Anti-Asthmatic Agents therapeutic use, Asthma complications, Canada, Child, Preschool, Glucocorticoids therapeutic use, Humans, Infant, Referral and Consultation, Respiratory Function Tests, Asthma diagnosis, Asthma therapy, Disease Management
- Abstract
Asthma often starts before six years of age. However, there remains uncertainty as to when and how a preschool-age child with symptoms suggestive of asthma can be diagnosed with this condition. This delays treatment and contributes to both short- and long-term morbidity. Members of the Canadian Thoracic Society Asthma Clinical Assembly partnered with the Canadian Paediatric Society to develop a joint working group with the mandate to develop a position paper on the diagnosis and management of asthma in preschoolers. In the absence of lung function tests, the diagnosis of asthma should be considered in children one to five years of age with frequent (≥ 8 days/month) asthma-like symptoms or recurrent (≥ 2) exacerbations (episodes with asthma-like signs). The diagnosis requires the objective document of signs or convincing parent-reported symptoms of airflow obstruction (improvement in these signs or symptoms with asthma therapy), and no clinical suspicion of an alternative diagnosis. The characteristic feature of airflow obstruction is wheezing, commonly accompanied by difficulty breathing and cough. Reversibility with asthma medications is defined as direct observation of improvement with short-acting ß2-agonists (SABA) (with or without oral corticosteroids) by a trained health care practitioner during an acute exacerbation (preferred method). However, in children with no wheezing (or other signs of airflow obstruction) on presentation, reversibility may be determined by convincing parental report of a symptomatic response to a three-month therapeutic trial of a medium dose of inhaled corticosteroids with as-needed SABA (alternative method), or as-needed SABA alone (weaker alternative method). The authors provide key messages regarding in whom to consider the diagnosis, terms to be abandoned, when to refer to an asthma specialist and the initial management strategy. Finally, dissemination plans and priority areas for research are identified.
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- 2015
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21. The role of nutrition for pressure ulcer management: national pressure ulcer advisory panel, European pressure ulcer advisory panel, and pan pacific pressure injury alliance white paper.
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Posthauer ME, Banks M, Dorner B, and Schols JM
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- Humans, Malnutrition diagnosis, Nutritional Status, Pressure Ulcer etiology, Disease Management, Malnutrition complications, Malnutrition therapy, Pressure Ulcer therapy
- Abstract
Nutrition and hydration play an important role in preserving skin and tissue viability and in supporting tissue repair for pressure ulcer (PrU) healing. The majority of research investigating the relationship between nutrition and wounds focuses on PrUs. This white paper reviews the 2014 National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance Nutrition Guidelines and discusses nutrition strategies for PrU management.
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- 2015
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22. Diagnosis and treatment of iron deficiency in patients with heart failure: expert position paper from French cardiologists.
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Cohen-Solal A, Leclercq C, Mebazaa A, De Groote P, Damy T, Isnard R, and Galinier M
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- France, Heart Failure therapy, Humans, Anemia, Iron-Deficiency complications, Anemia, Iron-Deficiency diagnosis, Anemia, Iron-Deficiency therapy, Biomarkers blood, Disease Management, Heart Failure complications, Practice Guidelines as Topic
- Abstract
The prevalence of iron deficiency is high -even in the absence of anaemia- in patients with chronic heart failure (HF). Although iron deficiency is easily diagnosed with two biomarkers (serum ferritin and transferrin saturation), it is underdiagnosed in patients with HF. Iron is not only necessary for red blood cells, but also for cells in tissues with high-energy demands (heart, muscle, brain). Even before the onset of anaemia, HF patients with iron deficiency have decreased physical and cognitive performances and a poorer quality of life. Moreover, iron deficiency is a risk factor, independent of anaemia, of unfavourable outcome (death or heart transplantation) in patients with chronic HF. Several randomized controlled studies have shown improvement in exercise capacity, New York Heart Association functional class and quality of life after correction of iron deficiency. The results of these clinical trials, which are supported by European guidelines, suggest considering iron deficiency in HF as a possible therapeutic target., (Copyright © 2014. Published by Elsevier Masson SAS.)
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- 2014
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23. What is a "Distinctive Nutritional Requirement"? A Position Paper of the Healthcare Nutrition Council.
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Chmielecki, Katie, Dockter, Berit, Johnson, Wendy, Jurch, Madeline, Pacht, Pamela, and Rostorfer, Jena
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- *
NUTRITIONAL status , *DISEASE management , *MEDICAL care , *ENTERAL feeding , *NUTRITION , *DIET therapy , *NUTRITIONAL requirements - Abstract
The Healthcare Nutrition Council (HNC) represents manufacturers of enteral nutrition formulas and oral nutrition supplements, including those categorized as medical foods and parenteral nutrition. HNC member companies, Abbott's Nutrition Division, Nestlé Health Science, and Nutricia North America, a subsidiary of Danone S.A., manufacture a majority of the medical foods consumed in the United States. HNC is proposing a modernized interpretation of the medical food framework to reflect the evolution of nutrition science and health care. The medical food category was first defined in 1988 as part of the Orphan Drug Act. Since then, the scientific community's understanding of nutrition and the role it can play in disease management has progressed. HNC believes that a patient-centric approach is needed to foster research and innovation and to position medical foods as a viable solution in the dietary management of disease. HNC proposes that distinctive nutritional requirements refer to the clinical need for a specific nutritional intake (compared with the intake of healthy populations), which may exist by reason of abnormal physiologic manifestation or physical impairment associated with a disease or condition. The dietary management of these diseases and conditions results in clinically meaningful improvements, including but not limited to nutritional status, health outcomes, or quality of life. HNC believes that abnormal physiologic manifestation or physical impairment would include a limited, impaired, or disturbed capacity to ingest, digest, absorb, metabolize, or excrete ordinary food or certain nutrients or metabolites or other medically determined requirements for nutrients or other food substances of biological value. HNC recommends our position be considered as we build consensus across the industry. We request that the Food and Drug Administration modify and codify the current definition to reflect this. Patients and the health care system will benefit from a strong regulatory interpretation of the medical foods framework. [ABSTRACT FROM AUTHOR]
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- 2023
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24. Telemedicine and Digital Medicine in the Clinical Management of Hypertension and Hypertension-Related Cardiovascular Diseases: A Position Paper of the Italian Society of Arterial Hypertension (SIIA).
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Minuz, Pietro, Albini, Fabio Lucio, Imbalzano, Egidio, Izzo, Raffaele, Masi, Stefano, Pengo, Martino F., Pucci, Giacomo, Scalise, Filippo, Salvetti, Massimo, Tocci, Giuliano, Cicero, Arrigo, Iaccarino, Guido, Savoia, Carmine, Sechi, Leonardo, Parati, Gianfranco, Borghi, Claudio, Volpe, Massimo, Ferri, Claudio, Grassi, Guido, and Muiesan, Maria Lorenza
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- *
KIDNEY disease risk factors , *HYPERTENSION , *CARDIOVASCULAR diseases risk factors , *MEDICAL quality control , *CEREBROVASCULAR disease , *DIGITAL technology , *MOBILE apps , *DIGITAL health , *RISK assessment , *INTERPROFESSIONAL relations , *AMBULATORY blood pressure monitoring , *QUALITY assurance , *PATIENT compliance , *TELEMEDICINE , *DISEASE management , *HEALTH promotion , *DISEASE complications - Abstract
High blood pressure is the leading cause of death and disability globally and an important treatable risk factor for cardiovascular, cerebrovascular and chronic kidney diseases. Digital technology, including mobile health solutions and digital therapy, is expanding rapidly in clinical medicine and has the potential to improve the quality of care and effectiveness of drug treatment by making medical interventions timely, tailored to hypertensive patients' needs and by improving treatment adherence. Thus, the systematic application of digital technologies could support diagnosis and awareness of hypertension and its complications, ultimately leading to improved BP control at the population level. The progressive implementation of digital medicine in the national health systems must be accompanied by the supervision and guidance of health authorities and scientific societies to ensure the correct use of these new technologies with consequent maximization of the potential benefits. The role of scientific societies in relation to the rapid adoption of digital technologies, therefore, should encompass the entire spectrum of activities pertaining to their institutional role: information, training, promotion of research, scientific collaboration and advice, evaluation and validation of technological tools, and collaboration with regulatory and health authorities. [ABSTRACT FROM AUTHOR]
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- 2023
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25. Instrument-free single-step direct estimation of the plasma glucose level from one drop of blood using smartphone-interfaced analytics on a paper strip.
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Biswas, Sujay K., Chatterjee, Subhamoy, Laha, Sampad, Pakira, Victor, Som, Nirmal K., Saha, Satadal, and Chakraborty, Suman
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- *
BLOOD sugar , *CAPILLARY flow , *BLOOD volume , *DISEASE management , *COMMUNITY centers - Abstract
We demonstrated an instrument-free miniaturized adaptation of the laboratory gold standard methodology for the direct estimation of plasma glucose from a drop of whole blood using a low-cost single-user-step paper-strip sensor interfaced with a smartphone. Unlike a majority of the existing glucose meters that use whole blood-based indirect sensing technologies, our direct adaptation of the gold-standard laboratory benchmark could eliminate the possibilities of cross interference with other analytes present in the whole blood by facilitating an in situ plasma separation, capillary flow and colorimetric reaction occurring concomitantly, without incurring additional device complexity or embodiment. The test reagents were dispensed in lyophilized form, and the resulting paper strips were found to be stable over three months stored in a normal freezer, rendering easy adaptability commensurate with the constrained supply chains in extreme resource-poor settings. Quantitative results could be arrived at via a completely-automated mobile-app-based image analytics interface developed using dynamic machine learning, obviating manual interpretation. The tests were demonstrated to be of high efficacy, even when executed by minimally trained frontline personnel having no special skill of drawing precise volume of blood, on deployment at under-resourced community centres having no in-built or accessible healthcare infrastructure. Clinical validation using 220 numbers of human blood samples in a double-blinded manner evidenced sensitivity and specificity of 98.11% and 96.7%, respectively, as compared to the results obtained from a laboratory-benchmarked biochemistry analyser, establishing its efficacy for public health and community disease management in resource-limited settings without any quality compromise of the test outcome. [ABSTRACT FROM AUTHOR]
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- 2022
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26. Peptide hormone analysis in diagnosis and treatment of Differences of Sex Development: joint position paper of EU COST Action ‘DSDnet’ and European Reference Network on Rare Endocrine Conditions
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Johannsen, T.H., Andersson, A.M., Ahmed, S.F., Rijke, Y.B. de, Greaves, R.F., Hartmann, M.F., Hiort, O., Holterhus, P.M., Krone, N.P., Kulle, A., Ljubicic, M.L., Mastorakos, G., McNeilly, J., Pereira, A.M., Saba, A., Wudy, S.A., Main, K.M., Juul, A., Working Group 3 H, Work Package 5 Diag, and Clinical Chemistry
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Anti-Mullerian Hormone ,Male ,medicine.medical_specialty ,Peptide Hormones ,Endocrinology, Diabetes and Metabolism ,Disorders of Sex Development ,030209 endocrinology & metabolism ,Context (language use) ,Physical examination ,Peptide hormone ,Bioinformatics ,03 medical and health sciences ,Rare Diseases ,0302 clinical medicine ,Endocrinology ,SDG 3 - Good Health and Well-being ,Tandem Mass Spectrometry ,Internal medicine ,medicine ,Humans ,Endocrine system ,Inhibins ,Cost action ,Immunoassay ,medicine.diagnostic_test ,business.industry ,Network on ,Disease Management ,General Medicine ,Luteinizing Hormone ,Reference Standards ,Europe ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Position paper ,Female ,Follicle Stimulating Hormone ,business ,Chromatography, Liquid ,Hormone - Abstract
Differences of Sex Development (DSD) comprise a variety of congenital conditions characterized by atypical chromosomal, gonadal, or anatomical sex. Diagnosis and monitoring of treatment of patients suspected of DSD conditions include clinical examination, measurement of peptide and steroid hormones, and genetic analysis. This position paper on peptide hormone analyses in the diagnosis and control of patients with DSD was jointly prepared by specialists in the field of DSD and/or peptide hormone analysis from the European Cooperation in Science and Technology (COST) Action DSDnet (BM1303) and the European Reference Network on rare Endocrine Conditions (Endo-ERN). The goal of this position paper on peptide hormone analysis was to establish laboratory guidelines that may contribute to improve optimal diagnosis and treatment control of DSD. The essential peptide hormones used in the management of patients with DSD conditions are follicle-stimulating hormone, luteinising hormone, anti-Müllerian hormone, and Inhibin B. In this context, the following position statements have been proposed: serum and plasma are the preferred matrices; the peptide hormones can all be measured by immunoassay, while use of LC-MS/MS technology has yet to be implemented in a diagnostic setting; sex- and age-related reference values are mandatory in the evaluation of these hormones; and except for Inhibin B, external quality assurance programs are widely available.
- Published
- 2020
27. Treatment of children with COVID-19: update of the Italian Society of Pediatric Infectious Diseases position paper
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Elisabetta Venturini, Carlotta Montagnani, Silvia Garazzino, Daniele Donà, Luca Pierantoni, Andrea Lo Vecchio, Andrzej Krzysztofiak, Giangiacomo Nicolini, Sonia Bianchini, Luisa Galli, Alberto Villani, Guido Castelli Gattinara, the Italian SITIP-SIP SARS-Cov-2 pediatric infection study group, Venturini, E., Montagnani, C., Garazzino, S., Dona, D., Pierantoni, L., Lo Vecchio, A., Krzysztofiak, A., Nicolini, G., Bianchini, S., Galli, L., Villani, A., and Gattinara, G. C.
- Subjects
Male ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,MEDLINE ,Pediatrics ,RJ1-570 ,Medical ,medicine ,Humans ,Disease management (health) ,Child ,Intensive care medicine ,Letter to the Editor ,book ,Societies, Medical ,Infectious Disease Medicine ,SARS-CoV-2 ,business.industry ,COVID-19 ,Disease Management ,Settore MED/38 ,Italy ,Practice Guidelines as Topic ,Pediatric Infectious Disease ,Position paper ,book.journal ,Female ,Periodicals as Topic ,Societies ,business ,Human - Published
- 2021
28. The COVID-19 Pandemic and the Need for an Integrated and Equitable Approach: An International Expert Consensus Paper
- Author
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Sergio Pillon, Mariella Catalano, Benjamin Brenner, Zsolt Pecsvarady, Ismail Elalamy, Joseph Lewis, Jean-Claude Wautrecht, D. Olinic, Vincent Maréchal, Mouna Sassi, Isabelle Mahé, Anna Falanga, Nusrat Jabeen, Charles A. Carter, Mary-Paula Colgan, Alexander Makatsariya, Alfonso Tafur, Kasse Aa, Tazi Mezalek Zoubida, Meletios-Athanasios Dimopoulos, Michèle Sabbah, Darko Antic, Yiannis Theodorou, Alex C. Spyropoulos, Vladimir Chekhonin, Meganathan Kannan, Katalin Farkas, Peter Klein-Wegel, Job Harenberg, P Massamba Mbaye, Joseph Gligorov, Manuel Monreal Bosch, Grigoris T. Gerotziafas, Pier Luigi Antignani, Hikmat Abdel-Razeq, James D. Douketis, Gerit Schernthaner, Petros Agathaggelou, Ali T. Taher, Jawed Fareed, Essam Abo Elnazar, Irina Panovska-Stavridis, Patrick Van Dreden, Fabio Leivano, Gerry Fowkes, Fakiha Siddiqui, Mark A. Ligocki, Tishya Indran, Kostantinos Konstantinidis, Bulent Kantarcioglu, Jin Shiomura, Bahare Fazeli, Chryssa Papageorgiou, Yongquan Gu, Anny Slama-Schwok, Eduardo Ramacciotti, Zenguo Zhai, Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Università degli Studi di Milano = University of Milan (UNIMI), Centre d'Immunologie et des Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Sechenov First Moscow State Medical University, Campbell University [Buies Creek, NC, USA] (CU), University of Karachi, Heidelberg University, Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), Loyola University [Chicago], Cyprus Institute (CyI), University of Belgrade [Belgrade], Nuova Villa Claudia [Rome, Italy] (NVC), Universidad Católica San Antonio de Murcia (UCAM), Rambam Health Care Campus [Haifa, Israel], Technion - Israel Institute of Technology [Haifa], Ministry of Health of the Russian Federation (MHRF), St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Trinity College Dublin, National and Kapodistrian University of Athens (NKUA), McMaster University [Hamilton, Ontario], Firestone Institute for Respiratory Health [Hamilton, ON, Canada] (FIRH), Ministry of Health [Saudi Arabia], Szent Imre Hospital [Budapest, Hungary] (SIH), Mashhad University of Medical Sciences, University of Edinburgh, Capital University of Medical Sciences [Beijing] (CUMS), Hôpitaux Universitaires de l'Est Parisien [Paris] (HUEP), Monash Medical Centre [Clayton, Australia], Central University of Tamil Nadu [Thiruvarur, India] (CUTN), Central University of Tamil Nadu (CUTN), Okmeydani Training and Research Hospital [Istanbul, Turkey] (OTRH), Centre International de Cancérologie de Dakar [Dakar, Senegal] (CICD), Aristotle University of Thessaloniki, University Hospital Southampton NHS Foundation Trust, Université Virtuelle du Sénégal [Dakar, Senegal] (UVS), Innovations thérapeutiques en hémostase (IThEM - U1140), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), University Clinic of Hematology [Skopje, Republic of North Macedonia] (UCH), University of Medicine and Pharmacy [Cluj-Napoca, Romania] (UMP), Service d'Anesthésie réanimation [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Flor Ferenc Teaching Hospital [Kistarcsa, Hungary] (2FTH), San Camillo Forlanini Hospital [Rome], Loyola University Medical Center (LUMC), Science Valley Research Institute [São Paulo, Brazil] (SVRI), King Hussein Cancer Center [Amman, Jordan] (KH2C), CHU Fattouma Bourguiba [Monastir] (HFB), Medizinische Universität Wien = Medical University of Vienna, Nobelpharma Co. Ltd. [Tokyo, Japan], Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), North Shore University Cardiologists [Skokie, Illinois, USA] (NSUC), American University of Beirut Faculty of Medicine and Medical Center (AUB), Klinikum Ernst von Bergmann [Potsdam, Germany] (KEVB), Peking University [Beijing], Chinese Academy of Medical Sciences [Beijing, China] (CAMS), Peking Union Medical College [Beijing, China], Université Mohammed V de Rabat [Agdal] (UM5), Scientific Reviewer Committee: Gregory Y H Lip, Michael Makris, Sam Schulman, Wolfgang Siess, Christian Weber, Sabbah, Michèle, Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), University of Milan, Centre d'Immunologie et de Maladies Infectieuses (CIMI), Università degli Studi di Milano-Bicocca [Milano] (UNIMIB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and University of Mohammed V
- Subjects
medicine.medical_specialty ,Telemedicine ,Economic growth ,COVID-19 Vaccines ,Population ,Psychological intervention ,Disease ,030204 cardiovascular system & hematology ,Risk Assessment ,Herd immunity ,03 medical and health sciences ,COVID-19 Testing ,0302 clinical medicine ,Consensus Paper ,Pandemic ,medicine ,[SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology ,Humans ,[SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology ,030212 general & internal medicine ,Disease management (health) ,education ,Pandemics ,thrombosis ,education.field_of_study ,SARS-CoV-2 ,Immunization Programs ,pandemic ,Public health ,COVID-19 ,Disease Management ,health care systems ,Hematology ,3. Good health ,Public Health ,Business - Abstract
Background One year after the declaration of the coronavirus disease 2019 (COVID-19) pandemic by the World Health Organization (WHO) and despite the implementation of mandatory physical barriers and social distancing, humanity remains challenged by a long-lasting and devastating public health crisis. Management Non-pharmacological interventions (NPIs) are efficient mitigation strategies. The success of these NPIs is dependent on the approval and commitment of the population. The launch of a mass vaccination program in many countries in late December 2020 with mRNA vaccines, adenovirus-based vaccines, and inactivated virus vaccines has generated hope for the end of the pandemic. Current Issues The continuous appearance of new pathogenic viral strains and the ability of vaccines to prevent infection and transmission raise important concerns as we try to achieve community immunity against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) and its variants. The need of a second and even third generation of vaccines has already been acknowledged by the WHO and governments. Perspectives There is a critical and urgent need for a balanced and integrated strategy for the management of the COVID-19 outbreaks organized on three axes: (1) Prevention of the SARS-CoV-2 infection, (2) Detection and early diagnosis of patients at risk of disease worsening, and (3) Anticipation of medical care (PDA). Conclusion The “PDA strategy” integrated into state policy for the support and expansion of health systems and introduction of digital organizations (i.e., telemedicine, e-Health, artificial intelligence, and machine-learning technology) is of major importance for the preservation of citizens' health and life world-wide.
- Published
- 2021
29. Sarcopenia: A Time for Action. An SCWD Position Paper
- Author
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Annemie M. W. J. Schols, Steven B. Heymsfield, Florian Strasser, Vickie E. Baracos, Wolfram Doehner, Carla M. Prado, Luigi Ferrucci, Andrew J.S. Coats, Elsa Dent, Michelangelo Mancuso, Maurizio Muscaritoli, Alfonso J. Cruz-Jentoft, Stephan von Haehling, Kamyar Kalantar-Zadeh, Francesco Landi, John E. Morley, Aminah Jatoi, Stefan D. Anker, Juergen M. Bauer, Alessandro Laviano, Mitja Lainscak, Jeffrey Crawford, Pulmonologie, and RS: NUTRIM - R3 - Respiratory & Age-related Health
- Subjects
0301 basic medicine ,Sarcopenia ,lcsh:Diseases of the musculoskeletal system ,Cachexia ,Disease ,Geriatric assessment ,Muscle ,Skeletal ,Muscle strength ,DOUBLE-BLIND ,Grip strength ,0302 clinical medicine ,Orthopedics and Sports Medicine ,VITAMIN-D ,Wasting ,ULTRASOUND ,PHYSICAL FUNCTION ,COPD ,education.field_of_study ,Disease Management ,lcsh:Human anatomy ,musculoskeletal system ,CANCER ,3. Good health ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Position Paper ,Disease Susceptibility ,medicine.symptom ,medicine.medical_specialty ,Population ,CACHEXIA SYNDROME ,lcsh:QM1-695 ,SKELETAL-MUSCLE MASS ,03 medical and health sciences ,Physical medicine and rehabilitation ,Physiology (medical) ,medicine ,Vitamin D and neurology ,Humans ,OLDER-ADULTS ,education ,business.industry ,Settore MED/09 - MEDICINA INTERNA ,medicine.disease ,body regions ,INTERNATIONAL-CONFERENCE ,030104 developmental biology ,CLINICAL-PRACTICE ,lcsh:RC925-935 ,business ,human activities - Abstract
The term sarcopenia was introduced in 1988. The original definition was a “muscle loss” of the appendicular muscle mass in the older people as measured by dual energy x‐ray absorptiometry (DXA). In 2010, the definition was altered to be low muscle mass together with low muscle function and this was agreed upon as reported in a number of consensus papers. The Society of Sarcopenia, Cachexia and Wasting Disorders supports the recommendations of more recent consensus conferences, i.e. that rapid screening, such as with the SARC‐F questionnaire, should be utilized with a formal diagnosis being made by measuring grip strength or chair stand together with DXA estimation of appendicular muscle mass (indexed for height2). Assessments of the utility of ultrasound and creatine dilution techniques are ongoing. Use of ultrasound may not be easily reproducible. Primary sarcopenia is aging associated (mediated) loss of muscle mass. Secondary sarcopenia (or disease‐related sarcopenia) has predominantly focused on loss of muscle mass without the emphasis on muscle function. Diseases that can cause muscle wasting (i.e. secondary sarcopenia) include malignant cancer, COPD, heart failure, and renal failure and others. Management of sarcopenia should consist of resistance exercise in combination with a protein intake of 1 to 1.5 g/kg/day. There is insufficient evidence that vitamin D and anabolic steroids are beneficial. These recommendations apply to both primary (age‐related) sarcopenia and secondary (disease related) sarcopenia. Secondary sarcopenia also needs appropriate treatment of the underlying disease. It is important that primary care health professionals become aware of and make the diagnosis of age‐related and disease‐related sarcopenia. It is important to address the risk factors for sarcopenia, particularly low physical activity and sedentary behavior in the general population, using a life‐long approach. There is a need for more clinical research into the appropriate measurement for muscle mass and the management of sarcopenia. Accordingly, this position statement provides recommendations on the management of sarcopenia and how to progress the knowledge and recognition of sarcopenia.
- Published
- 2019
30. The role of mobile health technologies in allergy care: An EAACI position paper
- Author
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Jean Bousquet, Jean-Christoph Roger J-P Caubet, James Gardner, Ralph Mösges, Simon Blank, Dermot Ryan, Alla Nakonechna, Daniel Perez-Formigo, Markus Ollert, Ignacio Esteban-Gorgojo, Ileana Ghiordanescu, Darío Antolín-Amérigo, Giovanni Battista Pajno, Jörn Wittmann, Jeroen Buters, Elisa Boni, Constantinos Pitsios, Karin Hoffmann-Sommergruber, Knut Brockow, Philippe Gevaert, Uwe Berger, Harmieke van Os-Medendorp, Matteo Bonini, Tania Elliott, Peter Hellings, Jennifer Shih, Marina Atanaskovic-Markovic, Salvatore Tripodi, Michael S. Blaiss, Stephanie Dramburg, A. Fusun Kalpaklioglu, Ioana Agache, Oliver Pfaar, Lauri-Ann Van der Poel, João Fonseca, Christian Apfelbacher, Ozlem Cavkaytar, Gilda Varricchi, Jose Oteros, S. Sanchez-Garcia, Farid Marmouz, Alberto Alvarez-Perea, Victoria Cardona, Ángela Meijide Calderón, Paolo Maria Matricardi, Michael Rudenko, Catalina Panaitescu, Margitta Worm, KKÜ, Ear, Nose and Throat, Kırıkkale Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kalpaklıoğlu, A. Fusun, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Hospital General Universitario 'Gregorio Marañón' [Madrid], Hospital Universitario Ramón y Cajal [Madrid], Universidad de Alcalá - University of Alcalá (UAH), University of Regensburg, University of Belgrade [Belgrade], Medizinische Universität Wien = Medical University of Vienna, Augusta University - Medical College of Georgia, University System of Georgia (USG), Center of Allergy & Environment (CK-CARE, ZAUM), Helmholtz-Zentrum München (HZM), German Research Center for Environmental Health - Helmholtz Center München (GmbH), Royal Brompton Hospital, Fondazione 'Policlinico Universitario A. Gemelli' [Rome], Università cattolica del Sacro Cuore [Roma] (Unicatt), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Technical University of Munich (TUM), Vall d'Hebron University Hospital [Barcelona], Geneva University Hospital (HUG), Istanbul Medeniyet University [Istanbul, Turquie] (IMU), New York University Langone Medical Center (NYU Langone Medical Center), NYU System (NYU), General Hospital of Villalba [Madrid], Center of Research in Health Technologies and Information Systems (CINTESIS), Universidade do Porto, Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Great North Children's Hospital, Partenaires INRAE, Newcastle University [Newcastle], Ghent University Hospital, Emergency University Hospital Elias, European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), University of Kirikkale, Hopital Réné Dubos, University of Vigo [ Pontevedra], University Hospital of Cologne [Cologne], Clinical Research International Ltd., Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool Hope University, Luxembourg Institute of Health (LIH), University of Southern Denmark (SDU), University of Messina, Romanian Primary Care Respiratory Group (RespiRo), Hospital Universitario de Torrejón, Univ Politecn Madrid, Ctr Tecnol Biomed, Pozuelo De Alarcon 28223, Madrid, Spain, Philipps Universität Marburg, University of Cyprus (UCY), Centre Harley Street Allergy Clinic, Centre of Medical Informatics [Edinburgh, UK] (Usher Institute of Population Health Sciences and Informatics), University of Edinburgh, Hospital Infantil Universitario Niño Jesús [Madrid, Spain] (HIUNJ), Institute of Health Carlos III, Emory University School of Medicine, Emory University [Atlanta, GA], Policlinico Casilino (Ospedale Policlinico Casilino), Medical Physics Department,Guy's and St Thomas'NHS Foundation Trust, London, UK, Medical Physics Department, London, UK, Medical Physics Department, Guy's and St Thomas'NHS Foundation Trust-Medical Physics Department, Guy's and St Thomas'NHS Foundation Trust, University Medical Center [Utrecht], 'Federico II' University of Naples Medical School, Transilvania University of Brasov, Helmholtz Zentrum München = German Research Center for Environmental Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma] (Unicatt), Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM), Universidade do Porto = University of Porto, Philipps Universität Marburg = Philipps University of Marburg, University of Cyprus [Nicosia] (UCY), Hospital Infantil Universitario Niño Jesús (HIUNJ), Salvy-Córdoba, Nathalie, Matricardi, Paolo Maria, Dramburg, Stephanie, Alvarez-Perea, Alberto, Antolín-Amérigo, Darío, Apfelbacher, Christian, Atanaskovic-Markovic, Marina, Berger, Uwe, Blaiss, Michael S, Blank, Simon, Boni, Elisa, Bonini, Matteo, Bousquet, Jean, Brockow, Knut, Buters, Jeroen, Cardona, Victoria, Caubet, Jean-Christoph, Cavkaytar, Özlem, Elliott, Tania, Esteban-Gorgojo, Ignacio, Fonseca, Joao A, Gardner, Jame, Gevaert, Philippe, Ghiordanescu, Ileana, Hellings, Peter, Hoffmann-Sommergruber, Karin, Kalpaklioglu, A Fusun, Marmouz, Farid, Meijide Calderón, Ángela, Mösges, Ralph, Nakonechna, Alla, Ollert, Marku, Oteros, José, Pajno, Giovanni, Panaitescu, Catalina, Perez-Formigo, Daniel, Pfaar, Oliver, Pitsios, Constantino, Rudenko, Michael, Ryan, Dermot, Sánchez-García, Silvia, Shih, Jennifer, Tripodi, Salvatore, Van der Poel, Lauri-Ann, van Os-Medendorp, Harmieke, Varricchi, Gilda, Wittmann, Jörn, Worm, Margitta, Agache, Ioana, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), and Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
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0301 basic medicine ,MESH: Drug Hypersensitivity ,MESH: Asthma ,Allergy ,MESH: Chronic Urticaria ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,immunoglobulin E ,0302 clinical medicine ,Immunology and Allergy ,Chronic Urticaria ,Position paper ,Disease management (health) ,MESH: Desensitization, Immunologic ,[SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology ,mHealth ,Self-management ,ddc:618 ,Health technology ,Disease Management ,allergen-immunotherapy ,Mobile Applications ,Telemedicine ,EAACI ,allergy ,digital health ,mobile health technology ,position paper ,3. Good health ,Dermatitis, Allergic Contact ,biomarker ,MESH: Mobile Applications ,Psychology ,allergic rhiniti ,Digital health ,Food Hypersensitivity ,[SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology ,allergen ,molecular allergology ,Immunology ,Internet privacy ,component-resolved-diagnosi ,Context (language use) ,Mobile health technology ,MESH: Disease Management ,Dermatitis, Atopic ,Drug Hypersensitivity ,03 medical and health sciences ,[SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics ,MESH: Dermatitis, Allergic Contact ,IgE test ,MESH: Dermatitis, Atopic ,Humans ,Mobile technology ,Anaphylaxis ,Physician-Patient Relations ,[SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics ,MESH: Humans ,business.industry ,Rhinitis, Allergic, Seasonal ,MESH: Rhinitis, Allergic, Seasonal ,asthma ,molecular spreading ,[SDV.MHEP.DERM] Life Sciences [q-bio]/Human health and pathology/Dermatology ,diagnostic algorithm ,MESH: Anaphylaxis ,030104 developmental biology ,030228 respiratory system ,Desensitization, Immunologic ,Digital Health ,Eaaci ,Mobile Health Technology ,Position Paper ,MESH: Telemedicine ,MESH: Food Hypersensitivity ,[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,MESH: Physician-Patient Relations ,business ,[SDV.MHEP.DERM]Life Sciences [q-bio]/Human health and pathology/Dermatology - Abstract
Oteros, Jose/0000-0002-9369-8633; Fonseca, Joao Almeida/0000-0002-0887-8796; Alvarez-Perea, Alberto/0000-0001-7417-7309; Oteros, Jose/0000-0002-9369-8633; Gevaert, Philippe/0000-0002-1629-8468; Antolin, Dario/0000-0001-5699-4022; Apfelbacher, Christian/0000-0003-3805-8219; Buters, Jeroen/0000-0003-3581-5472; Berger, Uwe E./0000-0002-9265-2131; Blank, Simon/0000-0002-5649-1078; Cardona, Victoria/0000-0003-2197-9767; Dramburg, Stephanie/0000-0002-9303-3260 WOS: 000486665800001 PubMed: 31230373 Mobile health (mHealth) uses mobile communication devices such as smartphones and tablet computers to support and improve health-related services, data and information flow, patient self-management, surveillance, and disease management from the moment of first diagnosis to an optimized treatment. The European Academy of Allergy and Clinical Immunology created a task force to assess the state of the art and future potential of mHealth in allergology. The task force endorsed the "Be He@lthy, Be Mobile" WHO initiative and debated the quality, usability, efficiency, advantages, limitations, and risks of mobile solutions for allergic diseases. The results are summarized in this position paper, analyzing also the regulatory background with regard to the "General Data Protection Regulation" and Medical Directives of the European Community. The task force assessed the design, user engagement, content, potential of inducing behavioral change, credibility/accountability, and privacy policies of mHealth products. The perspectives of healthcare professionals and allergic patients are discussed, underlining the need of thorough investigation for an effective design of mHealth technologies as auxiliary tools to improve quality of care. Within the context of precision medicine, these could facilitate the change in perspective from clinician- to patient-centered care. The current and future potential of mHealth is then examined for specific areas of allergology, including allergic rhinitis, aerobiology, allergen immunotherapy, asthma, dermatological diseases, food allergies, anaphylaxis, insect venom, and drug allergy. The impact of mobile technologies and associated big data sets are outlined. Facts and recommendations for future mHealth initiatives within EAACI are listed.
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- 2020
31. Optimal use of lipid-lowering therapy after acute coronary syndromes: A Position Paper endorsed by the International Lipid Expert Panel (ILEP)
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K. Dyrbus, Maciej Banach, Roman Margoczy, Daniel Pella, Michal Vrablík, Peter E. Penson, Zoltan Jarai, Matjaz Bunc, Charalambos Vlachopoulos, Željko Reiner, Stefania Lucia Magda, Dusko Vulic, Dan Gaita, Marek Gierlotka, Matias Trbušić, Petr Ostadal, Cristian Alexandru Udroiu, Eduard Margetic, Jan Fedacko, Azra Durak-Nalbantic, Dariusz Dudek, Zlatko Fras, and Banach M, Penson PE, Vrablik M, Bunc M, Dyrbus K, Fedacko J, Gaita D, Gierlotka M, Jarai Z, Magda SL, Margetic E, Margoczy R, Durak-Nalbantic A, Ostadal P, Pella D, Trbusic M, Udroiu CA, Vlachopoulos C, Vulic D, Fras Z, Dudek D, Reiner Ž, ACS EuroPath Central & South European Countries Project, Cicero AFG.
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0301 basic medicine ,RM ,medicine.medical_specialty ,Combination therapy ,PCSK9 inhibitor ,effectiveness ,Treatment goals ,Lipid-lowering therapy ,03 medical and health sciences ,0302 clinical medicine ,Ezetimibe ,medicine ,Humans ,Acute Coronary Syndrome ,Intensive care medicine ,Pharmacology ,Statins ,business.industry ,Atherosclerotic cardiovascular disease ,Anticholesteremic Agents ,PCSK9 ,Effectivene ,Disease Management ,Atherosclerosis ,Lipids ,030104 developmental biology ,PCSK9 inhibitors ,030220 oncology & carcinogenesis ,Position paper ,Safety ,business ,Very high risk ,medicine.drug - Abstract
Atherosclerotic cardiovascular disease (ASCVD) and consequent acute coronary syndromes (ACS) are substantial contributors to morbidity and mortality across Europe. Much of these diseases burden is modifiable, in particular by lipid-lowering therapy (LLT). Current guidelines are based on the sound premise that with respect to low density lipoprotein cholesterol (LDL-C), “lower is better for longer”, and the recent data have strongly emphasized the need of also “the earlier the better”. In addition to statins, which have been available for several decades, the availability of ezetimibe and inhibitors of proprotein convertase subtilisin/kexin type 9 (PCSK9) are additional very effective approach to LLT, especially for those at very high and extremely high cardiovascular risk. LLT is initiated as a response to an individual’s calculated risk of future ASCVD and is intensified over time in order to meet treatment goals. However, in real-life clinical practice goals are not met in a substantial proportion of patients. This Position Paper complements existing guidelines on the management of lipids in patients following ACS. Bearing in mind the very high risk of further events in ACS, we propose practical solutions focusing on immediate combination therapy in strict clinical scenarios, to improve access and adherence to LLT in these patients. We also define an ‘Extremely High Risk’ group of individuals following ACS, completing the attempt made in the recent European guidelines, and suggest mechanisms to urgently address lipid-medicated cardio-vascular risk in these patients.
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- 2021
32. Bibliometric study and review of Klotho research: global characteristics and trends from 2000 to 2023.
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Zhang FF, Xu YQ, Xiong JH, Hu JX, Zhu GS, and Cheng SM
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- Humans, China, Databases, Factual, Hypertrophy, Left Ventricular, Bibliometrics, Disease Management
- Abstract
Background: Although Klotho-related research has seen a significant upsurge, the field lacks comprehensive analytical representation and in-depth exploration of pertinent areas such as prevailing research trends and key focus areas., Method: This review presents a bibliometric analysis of literature data gathered from the Web of Science Core Collection databases from January 1, 2000, to April 30, 2023. Parameters such as co-authorship, co-citation, co-occurrence, and the emergence of publications, countries, categories, references, and keywords were scrutinized predominantly using Citespace software., Results: Our investigation amassed a total of 3548 papers, with the United States leading in the quantity of publications (1175, accounting for 33.12%), followed by China (867, representing 24.44%), and Japan (439, accounting for 12.37%). While the United States is preeminent in the overall volume of publications, Scotland holds prominence in terms of centrality. Out of a total of 96 subject categories, urology and nephrology (573), and endocrinology and metabolism (542) were the two leading domains of Klotho-related publications. The 2011 paper titled "FGF23 induces left ventricular hypertrophy" by Faul C et al. holds the distinction of being the most frequently cited. The keywords "fibroblast growth factor 23," "phosphate homeostasis," and "functional variants" demonstrated the highest intensity, underscoring the potential of these research areas., Conclusion: As the volume of literature grows, the role of Klotho in disease management and its applicability as a marker in disease progression warrant vigilant tracking and study., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)
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- 2024
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33. An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions
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Didier G. Ebo, Ingrid Terreehorst, Susanna Voltolini, Tomaz Garcez, Peter Kopač, Jose Julio Laguna, Paul-Michel Mertes, Pascale Dewachter, Kathrin Scherer, Lene H. Garvey, Anca Mirela Chiriac, Ear, Nose and Throat, and AII - Inflammatory diseases
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0301 basic medicine ,Hypersensitivity, Immediate ,Premedication ,Severity of Illness Index ,antibiotics ,alergija in imunologija -- diagnostika ,opioid analgesics ,0302 clinical medicine ,opioidni analgetiki ,Immunology and Allergy ,opioidi ,Incidence ,Disease Management ,preobčutljivost za zdravila -- diagnostika ,anafilaksija ,Phenotype ,Disease Susceptibility ,medicine.medical_specialty ,udc:616.097:(615.211+615.216.2) ,non-steroidal opioids ,Immunology ,anesthesia ,anti-inflammatory agents ,anestezija ,Diagnosis, Differential ,03 medical and health sciences ,allergy and immunology -- diagnosis ,antibakterijska sredstva ,anti-bacterial agents ,anesthetics ,medicine ,anaphylaxis ,Humans ,anestetiki ,nesteroidna protivnetna sredstva ,Intensive care medicine ,Perioperative Period ,Skin Tests ,drug hypersensitivity -- diagnosis ,Task force ,business.industry ,Diagnostic Tests, Routine ,Perioperative ,Immunoglobulin E ,030104 developmental biology ,030228 respiratory system ,Position paper ,Allergists ,Human medicine ,business ,antibiotiki - Abstract
Perioperative immediate hypersensitivity reactions are rare. Subsequent allergy investigation is complicated by multiple simultaneous drug exposures, the use of drugs with potent effects and the many differential diagnoses to hypersensitivity in the perioperative setting. The approach to the investigation of these complex reactions is not standardized, and it is becoming increasingly apparent that collaboration between experts in the field of allergy/immunology/dermatology and anaesthesiology is needed to provide the best possible care for these patients. The EAACI task force behind this position paper has therefore combined the expertise of allergists, immunologists and anaesthesiologists. The aims of this position paper were to provide recommendations for the investigation of immediate-type perioperative hypersensitivity reactions and to provide practical information that can assist clinicians in planning and carrying out investigations.
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- 2020
34. Highly cited papers in Takayasu arteritis on Web of Science and Scopus: cross-sectional analysis.
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Misra, Durga Prasanna, Agarwal, Vikas, Gasparyan, Armen Yuri, Zimba, Olena, and Sharma, Aman
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- *
GIANT cell arteritis , *TAKAYASU arteritis , *CROSS-sectional method , *RHEUMATISM , *RANDOMIZED controlled trials , *DISEASE management , *REGRESSION analysis - Abstract
Background: Takayasu arteritis (TAK) is a large vessel vasculitis affecting relatively younger population. Since literature on bibliometric analysis of TAK is scarce, we analyzed top-cited articles in TAK to address this knowledge gap. Methods: We analyzed the top hundred cited articles in TAK on Web of Science and Scopus for time of publication, article type, country of origin, source journal, and authors. Furthermore, we conducted univariable- and multivariable-adjusted linear regression analyses to explore associations of rank of cited articles, mean number of annual citations, and total citations with traditional (journal impact factor, CiteScore) and alternative (PlumX) metrics. Results: Concordance between databases was 76%. Most top-cited articles were from the USA, Japan, or the UK, and published in Annals of the Rheumatic Diseases, Arthritis and Rheumatism, and Circulation and Rheumatology (Oxford). Original articles comprised a majority of these top-cited articles. Articles describing criteria or disease management recommendations received the highest mean number of citations. Performing multivariable-adjusted linear regression analyses, years of publication associated with mean annual citations on Web of Science as well as total citations across databases (p < 0.01). The 2-year JIF significantly associated with mean annual citations on Web of Science (p = 0.047). On Scopus, the number of captures denoted under PlumX metrics consistently associated with citations (p < 0.001). Conclusion: Both traditional and alternative metrics associate with higher citations in TAK. Development of disease assessment and clinical practice guidelines and conduct and reporting of randomized controlled trials to guide TAK management are important research areas. The key points themselves are all right. Key Points • A majority of top-cited papers in TAK are original articles. • Both traditional and alternative metrics associate with number of citations for these papers. • Recommendations for disease assessment or clinical practice and clinical trials are important research agenda in TAK. [ABSTRACT FROM AUTHOR]
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- 2022
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35. One Health: EAACI Position Paper on coronaviruses at the human‐animal interface, with a specific focus on comparative and zoonotic aspects of SARS‐CoV‐2.
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Korath, Anna D. J., Janda, Jozef, Untersmayr, Eva, Sokolowska, Milena, Feleszko, Wojciech, Agache, Ioana, Adel Seida, Ahmed, Hartmann, Katrin, Jensen‐Jarolim, Erika, and Pali‐Schöll, Isabella
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- *
COVID-19 , *SARS-CoV-2 , *CORONAVIRUSES , *COVID-19 pandemic , *DISEASE management - Abstract
The latest outbreak of a coronavirus disease in 2019 (COVID‐19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), evolved into a worldwide pandemic with massive effects on health, quality of life, and economy. Given the short period of time since the outbreak, there are several knowledge gaps on the comparative and zoonotic aspects of this new virus. Within the One Health concept, the current EAACI position paper dwells into the current knowledge on SARS‐CoV‐2's receptors, symptoms, transmission routes for human and animals living in close vicinity to each other, usefulness of animal models to study this disease and management options to avoid intra‐ and interspecies transmission. Similar pandemics might appear unexpectedly and more frequently in the near future due to climate change, consumption of exotic foods and drinks, globe‐trotter travel possibilities, the growing world population, the decreasing production space, declining room for wildlife and free‐ranging animals, and the changed lifestyle including living very close to animals. Therefore, both the society and the health authorities need to be aware and well prepared for similar future situations, and research needs to focus on prevention and fast development of treatment options (medications, vaccines). [ABSTRACT FROM AUTHOR]
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- 2022
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36. Management of status epilepticus in adults. Position paper of the Italian League against Epilepsy
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Francesco Brigo, Stefano Meletti, Oriano Mecarelli, Roberto Michelucci, Monica Ferlisi, Nicola Specchio, Fabio Minicucci, Stefano Sartori, Paolo Tinuper, Massimo Mastrangelo, Umberto Aguglia, Minicucci F., Ferlisi M., Brigo F., Mecarelli O., Meletti S., Aguglia U., Michelucci R., Mastrangelo M., Specchio N., Sartori S., and Tinuper P.
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Adult ,medicine.medical_specialty ,Epileptologist ,Antiepileptic drugs ,Status epilepticus ,Neurosurgical Procedures ,03 medical and health sciences ,Behavioral Neuroscience ,Epilepsy ,0302 clinical medicine ,Status Epilepticus ,Medicine ,Humans ,Position paper ,030212 general & internal medicine ,Italian League against Epilepsy ,Treatment ,Disease management (health) ,Anticonvulsants ,Italy ,Randomized Controlled Trials as Topic ,Disease Management ,business.industry ,Status epilepticu ,Neurointensive care ,medicine.disease ,nervous system diseases ,Neurology ,Family medicine ,Neurology (clinical) ,Levetiracetam ,Neurosurgery ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Antiepileptic drug ,medicine.drug - Abstract
Since the publication of the Italian League Against Epilepsy guidelines for the treatment of status epilepticus in 2006, advances in the field have ushered in improvements in the therapeutic arsenal. The present position paper provides neurologists, epileptologists, neurointensive care specialists, and emergency physicians with updated recommendations for the treatment of adult patients with status epilepticus. The aim is to standardize treatment recommendations in the care of this patient population.
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- 2020
37. Management of pulmonary ground-glass opacities: a position paper from a panel of experts of the Italian Society of Thoracic Surgery (SICT)
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Filippo Lococo, Ottavio Rena, Federico Davini, Lococo A, Gianluca Guggino, William Grossi, Antonio Fabillian De Filippis, Giuseppe Cardillo, Giacomo Cusumano, Giuseppe Marulli, Gianluca Pariscenti, and Luca Luzzi
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Consensus ,Lung Neoplasms ,media_common.quotation_subject ,Modified delphi ,Jury ,Multidisciplinary approach ,Medical ,Settore MED/21 - CHIRURGIA TORACICA ,Voting ,Expert meeting ,Medicine ,Humans ,Medical physics ,Societies, Medical ,media_common ,GGN ,GGO ,business.industry ,Disease Management ,Thoracic Surgery ,Thoracic Surgical Procedures ,Italy ,Cardiothoracic surgery ,Radiological weapon ,Position paper ,Surgery ,Consensus conference ,Pulmonary nodules ,Pulmonary resection ,Societies ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJECTIVES A significant gap in our knowledge of how to manage pulmonary ground-glass opacities (GGOs) still exists. Accordingly, there is a lack of consensus among clinicians on this topic. The Italian Society of Thoracic Surgery (Società Italiana di Chirurgia Toracica, SICT) promoted a national expert meeting to provide insightful guidance for clinical practice. Our goal was to publish herein the final consensus document from this conference. METHODS The working panel of the PNR group (Pulmonary Nodules Recommendation Group, a branch of the SICT) together with 5 scientific supervisors (nominated by the SICT) identified a jury of expert thoracic surgeons who organized a multidisciplinary meeting to propose specific statements (n = 29); 73 participants discussed and voted on statements using a modified Delphi process (repeated iterations of anonymous voting over 2 rounds with electronic support) requiring 70% agreement to reach consensus on a statement. RESULTS Consensus was reached on several critical points in GGO management, in particular on the definition of GGO, radiological and radiometabolic evaluation, indications for a non-surgical biopsy, GGO management based on radiological characteristics, surgical strategies (extension of pulmonary resection and lymphadenectomy) and radiological surveillance. A list of 29 statements was finally approved. CONCLUSIONS The participants at this national expert meeting analysed this challenging topic and provided a list of suggestions for health institutions and physicians with practical indications for GGO management.
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- 2019
38. LFA: The Mysterious Paper-Based Biosensor: A Futuristic Overview.
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Singh, Saumitra, Hasan, Mohd. Rahil, Jain, Akshay, Pilloton, Roberto, and Narang, Jagriti
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MOLECULAR diagnosis ,DIAGNOSIS ,BIOSENSORS ,MEDICAL care costs ,DISEASE management ,COMMUNICABLE diseases - Abstract
Lateral flow assay (LFA) is emerging as one of the most popular paper-based biosensors in the field of the diagnostic industry. LFA fills all the gaps between diagnosis and treatment as it provides beneficial qualities to users such as quick response, Point-of-care appeal, early detection, low cost, and effective and sensitive detections of various infectious diseases. These benefits increase LFA's dependability for disease management because rapid and accurate disease diagnosis is a prerequisite for effective medication. Only 2% of overall healthcare expenditures, according to Roche Molecular Diagnostics, are spent on in vitro diagnostics, even though 60% of treatment choices are based on this data. To make LFA more innovative, futuristic plans have been outlined in many reports. Thus, this review reports on very knowledgeable literature discussing LFA and its development along with recent futuristic plans for LFA-based biosensors that cover all the novel features of the improvement of LFA. LFA might therefore pose a very significant economic success and have a significant influence on medical diagnosis. [ABSTRACT FROM AUTHOR]
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- 2023
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39. Editor’s Choice - Acute Cardiovascular Care Association Position Paper on Intensive Cardiovascular Care Units: An update on their definition, structure, organisation and function
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Sigrun Halvorsen, Avi Shimony, Pranas Šerpytis, Zaza Iakobishvili, Robert Zukermann, Elia De Maria, Donna Fitzsimons, Gianni Casella, Ahmed Magdy, Eric Bonnefoy-Cudraz, François Roubille, Doron Zahger, Richard Rokyta, Elina Trendafilova, Héctor Bueno, Jorge Mimoso, Endre Zima, Christiaan J. Vrints, Marco Tubaro, Christian Hassager, David Walker, Toomas Marandi, Susana Price, Diana Tint, Maddalena Lettino, Alexander Parkhomenko, Janina Stępińska, Hospices Civils de Lyon (HCL), Hospital General Universitario 'Gregorio Marañón' [Madrid], Department of Cardiology, Copenhagen University Hospital-Rigshospitalet [Copenhagen], Copenhagen University Hospital, Charles University Hospital, Charles University [Prague] (CU), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), and University of Arizona
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medicine.medical_specialty ,Critical Care ,[SDV]Life Sciences [q-bio] ,media_common.quotation_subject ,Cardiology ,Cardiovascular care ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,Acute cardiovascular care ,Unit (housing) ,03 medical and health sciences ,0302 clinical medicine ,Case mix index ,Multidisciplinary approach ,Critical care nursing ,medicine ,Humans ,030212 general & internal medicine ,Intensive care medicine ,Function (engineering) ,Societies, Medical ,Management structure ,media_common ,ICCU ,business.industry ,Coronary Care Units ,Disease Management ,intensive cardiovascular care units ,General Medicine ,3. Good health ,Europe ,Cardiovascular Diseases ,Acute Disease ,Position paper ,Human medicine ,Periodicals as Topic ,Cardiology and Cardiovascular Medicine ,business - Abstract
International audience; Acute cardiovascular care has progressed considerably since the last position paper was published 10 years ago. It is now a well-defined, complex field with demanding multidisciplinary teamworking. The Acute Cardiovascular Care Association has provided this update of the 2005 position paper on acute cardiovascular care organisation, using a multinational working group. The patient population has changed, and intensive cardiovascular care units now manage a large range of conditions from those simply requiring specialised monitoring, to critical cardiovascular diseases with associated multi-organ failure. To describe better intensive cardiovascular care units case mix, acuity of care has been divided into three levels, and then defining intensive cardiovascular care unit functional organisation. For each level of intensive cardiovascular care unit, this document presents the aims of the units, the recommended management structure, the optimal number of staff, the need for specially trained cardiologists and cardiovascular nurses, the desired equipment and architecture, and the interaction with other departments in the hospital and other intensive cardiovascular care units in the region/area. This update emphasises cardiologist training, referring to the recently updated Acute Cardiovascular Care Association core curriculum on acute cardiovascular care. The training of nurses in acute cardiovascular care is additionally addressed. Intensive cardiovascular care unit expertise is not limited to within the unit's geographical boundaries, extending to different specialties and subspecialties of cardiology and other specialties in order to optimally manage the wide scope of acute cardiovascular conditions in frequently highly complex patients. This position paper therefore addresses the need for the inclusion of acute cardiac care and intensive cardiovascular care units within a hospital network, linking university medical centres, large community hospitals, and smaller hospitals with more limited capabilities.
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- 2017
40. Mental health-related risk factors and interventions in patients with heart failure: a position paper endorsed by the European Association of Preventive Cardiology (EAPC)
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Karl-Heinz Ladwig, Thomas C Baghai, Frank Doyle, Mark Hamer, Christoph Herrmann-Lingen, Evelyn Kunschitz, Cédric Lemogne, Margarita Beresnevaite, Angelo Compare, Roland von Känel, Hendrik B Sager, Willem Johan Kop, University of Zurich, Ladwig, Karl-Heinz, Technische Universität München = Technical University of Munich (TUM), German Center for Cardiovascular Research (DZHK), Berlin Institute of Health (BIH), University of Regensburg, Royal College of Surgeons in Ireland (RCSI), University College of London [London] (UCL), Georg-August-University = Georg-August-Universität Göttingen, Hanusch Krankenhaus [Vienna, Austria] (HK), Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hôpital Hôtel-Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Lithuanian University of health Sciences [Kaunas], University of Bergamo, Centro Diagnostico Italiano (CDI), Universität Zürich [Zürich] = University of Zurich (UZH), Tilburg University [Tilburg], Netspar, and Martinez Rico, Clara
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Heart failure ,psychological factors ,depression ,anxiety ,palliative care ,review ,risk factors ,psychosocial ,Epidemiology ,[SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Cardiology ,ATHEROSCLEROSIS RISK ,610 Medicine & health ,Review ,Anxiety ,2705 Cardiology and Cardiovascular Medicine ,IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS ,Risk Factors ,Settore M-PSI/08 - Psicologia Clinica ,ANTIDEPRESSANT USE ,Humans ,Prospective Studies ,COGNITIVE-BEHAVIORAL THERAPY ,ALL-CAUSE MORTALITY ,Heart Failure ,Depression ,Palliative Care ,Psychological Factors ,DISEASE MANAGEMENT ,Mental Health ,10057 Klinik für Konsiliarpsychiatrie und Psychosomatik ,MYOCARDIAL-INFARCTION ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,DEPRESSIVE SYMPTOMS ,Chronic Disease ,VENTRICULAR ASSIST DEVICES ,Cardiology and Cardiovascular Medicine ,Psychosocial ,2713 Epidemiology - Abstract
The prevalence and public health burden of chronic heart failure (CHF) in Europe is steadily increasing mainly caused by the ageing population and prolonged survival of patients with CHF. Frequent hospitalizations, high morbidity and mortality rates, and enormous healthcare costs contribute to the health-related burden. However, multidisciplinary frameworks that emphasize effective long-term management and the psychological needs of the patients are sparse. The present position paper endorsed by the European Association of Preventive Cardiology (EAPC) provides a comprehensive overview on the scientific evidence of psychosocial aspects of heart failure (HF). In order to synthesize newly available information and reinforce best medical practice, information was gathered via literature reviews and consultations of experts. It covers the evidence for aetiological and prospective psychosocial risk factors and major underlying psycho-biological mechanisms. The paper elucidates the need to include psychosocial aspects in self-care concepts and critically reviews the current shortcomings of psychotherapeutic and psycho-pharmacological interventions. It also highlights the need for involvement of psychological support in device therapy for patients with HF and finally calls for better palliative care in the final stage of HF progression.
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- 2022
- Full Text
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41. Management of adverse events associated with idelalisib treatment in chronic lymphocytic leukemia and follicular lymphoma: A multidisciplinary position paper
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Pier Luigi Zinzani, Stefano Fagiuoli, Paolo Ghia, Antonio Cuneo, Giovanni Barosi, Alfredo Marzano, Romano Danesi, Pierluigi Viale, Marco Montillo, Venerino Poletti, Cuneo, Antonio, Barosi, Giovanni, Danesi, Romano, Fagiuoli, Stefano, Ghia, Paolo, Marzano, Alfredo, Montillo, Marco, Poletti, Venerino, Viale, Pierluigi, Zinzani, Pier Luigi, Cuneo, A, Barosi, G, Danesi, R, Fagiuoli, S, Ghia, P, Marzano, A, Montillo, M, Poletti, V, Viale, P, and Zinzani, P
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Oncology ,Cancer Research ,Adverse events ,chronic lymphocytic leukemia ,follicular lymphoma ,idelalisib ,Chronic lymphocytic leukemia ,adverse event ,Follicular lymphoma ,Review ,Antineoplastic Agent ,0302 clinical medicine ,hemic and lymphatic diseases ,Antineoplastic Combined Chemotherapy Protocols ,Cytochrome P-450 CYP3A ,Drug Interactions ,Disease management (health) ,Lymphoma, Follicular ,Disease Management ,Hematology ,General Medicine ,Colitis ,Algorithm ,Aldehyde Oxidase ,Drug Interaction ,030220 oncology & carcinogenesis ,Idelalisib ,Algorithms ,Human ,Diarrhea ,medicine.medical_specialty ,Reviews ,Antineoplastic Agents ,Quinazolinone ,NO ,03 medical and health sciences ,Internal medicine ,medicine ,Animals ,Humans ,Clinical significance ,Adverse effect ,Purine ,Quinazolinones ,Pneumonitis ,adverse events ,Antineoplastic Combined Chemotherapy Protocol ,Animal ,business.industry ,medicine.disease ,Leukemia, Lymphocytic, Chronic, B-Cell ,Purines ,Position paper ,business ,Coliti ,030215 immunology - Abstract
The introduction of new therapeutic agents in chronic lymphocytic leukemia (CLL) and follicular lymphoma (FL), including the new kinase inhibitor idelalisib, has changed the therapeutic landscape of these diseases. However, the use of idelalisib is associated with a peculiar profile of side effects, which require an optimization of the current approach to prophylaxis and supportive treatment. Moving from the recognition that the abovementioned issue represents an unmet need in CLL and FL, a multidisciplinary panel of experts was convened to produce a consensus document aiming to provide practical recommendations for the management of the side effects during idelalisib therapy for CLL and FL. The present publication represents a consensus document from a series of meetings held during 2017. The Panel generated clinical key questions using the criterion of clinical relevance through a Delphi process and explored 4 domains, ie, diarrhea/colitis, transaminitis, pneumonitis, and infectious complications. Using the consensus method, the Panel was able to shape recommendations which may assist hematologist to minimize adverse events and guarantee adherence to treatment in patients with CLL and FL candidate to receive idelalisib.
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- 2019
42. Diagnosis and management of NSAID-Exacerbated Respiratory Disease (N-ERD)--a EAACI position paper
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María José Torres, Hae-Sim Park, Masami Taniguchi, Marek Sanak, Aleksandra Wardzyńska, Joaquim Mullol, Ioana Agache, Matteo Bonini, Marek L. Kowalski, Mario Sánchez-Borges, Sevim Bavbek, Arzu Bakirtas, Ludger Klimek, Miguel Blanca, Enrico Heffler, Ewa Nizankowska-Mogilnicka, Glenis Scadding, Andrew A. White, Grazyna Bochenek, Silvia Sanchez-Garcia, and Tanya M. Laidlaw
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0301 basic medicine ,medicine.medical_specialty ,nasal polyps...) sinusitis ,asthma treatment ,sinusitis ,Drug allergy ,Respiratory Tract Diseases ,Immunology ,Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO ,ENT (rhinitis ,03 medical and health sciences ,0302 clinical medicine ,Eosinophilic ,medicine ,nasal polyps…) ,Humans ,Immunology and Allergy ,Nasal polyps ,Sinusitis ,Intensive care medicine ,Asthma ,Rhinitis ,ENT (rhinitis, sinusitis, nasal polyps…) ,Aspirin ,business.industry ,AERD asthma asthma treatment drug allergy ENT (rhinitis ,Respiratory disease ,Anti-Inflammatory Agents, Non-Steroidal ,Disease Management ,asthma ,medicine.disease ,AERD ,030104 developmental biology ,030228 respiratory system ,drug allergy ,Position paper ,Asthma, Aspirin-Induced ,business ,Algorithms ,medicine.drug - Abstract
NSAID-exacerbated respiratory disease (N-ERD) is a chronic eosinophilic, inflammatory disorder of the respiratory tract occurring in patients with asthma and/or chronic rhinosinusitis with nasal polyps (CRSwNP), symptoms of which are exacerbated by NSAIDs, including aspirin. Despite some progress in understanding of the pathophysiology of the syndrome, which affects 1/10 of patients with asthma and rhinosinusitis, it remains a diagnostic and therapeutic challenge. In order to provide evidence-based recommendations for the diagnosis and management of N-ERD, a panel of international experts was called by the EAACI Asthma Section. The document summarizes current knowledge on the pathophysiology and clinical presentation of N-ERD pointing at significant heterogeneity of this syndrome. Critically evaluating the usefulness of diagnostic tools available, the paper offers practical algorithm for the diagnosis of N-ERD. Recommendations for the most effective management of a patient with N-ERD stressing the potential high morbidity and severity of the underlying asthma and rhinosinusitis are discussed and proposed. Newly described sub-phenotypes and emerging sub-endotypes of N-ERD are potentially relevant for new and more specific (eg, biological) treatment modalities. Finally, the document defines major gaps in our knowledge on N-ERD and unmet needs, which should be addressed in the future.
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- 2019
43. EAACI position paper: Comparing insect hypersensitivity induced by bite, sting, inhalation or ingestion in human beings and animals
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Claudio Rhyner, Ralf S. Mueller, Eliane Isabelle Marti, Simon Blank, Ahmed Adel Seida, Douglas J. DeBoer, Kitty C.M. Verhoeckx, Isabella Pali-Schöll, Jozef Janda, Erika Jensen-Jarolim, University of Zurich, and Pali‐Schöll, Isabella
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medicine.medical_specialty ,Insecta ,media_common.quotation_subject ,Immunology ,610 Medicine & health ,Insect ,medicine.disease_cause ,Allergen ,10183 Swiss Institute of Allergy and Asthma Research ,Hypersensitivity ,medicine ,Animals ,Humans ,Ingestion ,Immunology and Allergy ,Public Health Surveillance ,Insect allergy ,Biology ,Skin ,media_common ,2403 Immunology ,Inhalation ,business.industry ,fungi ,Disease Management ,Insect Bites and Stings ,Allergens ,Dermatology ,Allergenic Molecules In Insects ,Comparative ,Insect Bite Hypersensitivity ,Insect Food Allergy ,Insect Venom Allergy ,Sting ,Phenotype ,Insect venom allergy ,2723 Immunology and Allergy ,Position paper ,Disease Susceptibility ,Symptom Assessment ,business - Abstract
Adverse reactions to insects occur in both human and veterinary patients. Systematic comparison may lead to improved recommendations for prevention and treatment in all species. In this position paper, we summarize the current knowledge on insect allergy induced via stings, bites, inhalation or ingestion, and compare reactions in companion animals to those in people. With few exceptions, the situation in human insect allergy is better documented than in animals. We focus on a review of recent literature and give overviews of the epidemiology and clinical signs. We discuss allergen sources and allergenic molecules to the extent described, and aspects of diagnosis, prophylaxis, management and therapy. © 2019 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
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- 2019
44. Position paper for management of elderly patients with pacemakers and implantable cardiac defibrillators: Groupe de Rythmologie et Stimulation Cardiaque de la Société Française de Cardiologie and Société Française de Gériatrie et Gérontologie
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Jacques Mansourati, Hugues Blangy, Jérôme Taieb, Franck Halimi, Olivier Hanon, Jean-Claude Deharo, Jean-Luc Pasquié, Pascal Defaye, Nicolas Sadoul, Benjamin Obadia, Didier Klug, Pierre Bordachar, Christine Alonso, Olivier Piot, Patrick Friocourt, Serge Boveda, Daniel Gras, Nicolas Clementy, Dominique Pavin, Laurent Fauchier, Frédéric Anselme, Service de Cardiologie B, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Clinique Ambroise Paré, Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], CHU Bordeaux [Bordeaux], Clinique Pasteur et Groupe Rythmologie Stimulation Cardiaque/SFC, Clinique Pasteur [Toulouse], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Cardiac Stimulation and Rhythmology, CHU Grenoble, Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Hospitalier de Blois (CHB), Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital privé de Parly-2, Service de Cardiologie A, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Optimisation des régulations physiologiques (ORPHY (EA 4324)), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Hôpital de la Timone [CHU - APHM] (TIMONE), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire d'Ecologie des Sols Tropicaux (LEST), Institut pour la Recherche et le Développement, Centre Hospitalier du Pays d'Aix, Centre cardiologique du Nord (CCN), Dpt Gériatrie [CHU Broca], AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), MORNET, Dominique, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes (UN), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de cardiologie et maladies vasculaires, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Laboratoire d'économie et de sociologie du travail (LEST), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Médicaments : Dynamique Intracellulaire et Architecture Nucléaire (MéDIAN), Université de Reims Champagne-Ardenne (URCA)-Centre National de la Recherche Scientifique (CNRS), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université
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Pacemaker, Artificial ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,Cardiology ,Cardiac resynchronization therapy ,Disease ,030204 cardiovascular system & hematology ,General status ,03 medical and health sciences ,Elderly ,0302 clinical medicine ,Older patients ,Internal medicine ,Implantable cardioverter defibrillator ,medicine ,Humans ,030212 general & internal medicine ,Societies, Medical ,Aged ,Heart Failure ,Resynchronisation cardiaque ,business.industry ,Mortality rate ,Défibrillateur automatique implantable ,Disease Management ,Arrhythmias, Cardiac ,General Medicine ,Implantable cardioverter-defibrillator ,medicine.disease ,Defibrillators, Implantable ,3. Good health ,Pacemaker ,[SDV] Life Sciences [q-bio] ,Position paper ,France ,Cardiac pacing ,Cardiology and Cardiovascular Medicine ,business ,Sujet âgé ,Atrioventricular block - Abstract
International audience; Despite the increasingly high rate of implantation of pacemakers (PMs) and implantable cardioverter defibrillators (ICDs) in elderly patients, data supporting their clinical and cost-effectiveness in this age stratum are ambiguous and contradictory. We reviewed the data regarding the applicability, safety and effectiveness of conventional pacing, ICDs and cardiac resynchronization therapy (CRT) in elderly patients. Although periprocedural risk may be slightly higher in the elderly, the implantation procedure for PMs and ICDs is still relatively safe in this age group. In older patients with sinus node disease, the general consensus is that DDD pacing with the programming of an algorithm to minimize ventricular pacing is preferred. In very old patients presenting with intermittent or suspected atrioventricular block, VVI pacing may be appropriate. In terms of correcting potentially life-threatening arrhythmias, the effectiveness of ICD therapy is similar in older and younger individuals. However, the assumption of persistent ICD benefit in the elderly population is questionable, as any advantageous effect of the device on arrhythmic death may be attenuated by higher total non-arrhythmic mortality. While septuagenarians and octogenarians have higher annual all-cause mortality rates, ICD therapy may remain effective in selected patients at high risk of arrhythmic death and with minimum comorbidities despite advanced age. ICD implantation among the elderly, as a group, may not be cost-effective, but the procedure may reach cost-effectiveness in those expected to live more than 5-7years after implantation. Elderly patients usually experience significant functional improvement after CRT, similar to that observed in middle-aged patients. Management of CRT non-responders remains globally the same, while considering a less aggressive approach in terms of reinterventions (revision of left ventricular [LV] lead placement, addition of a right ventricular or LV lead, LV endocardial pacing configuration). Overall, physiological age, general status and comorbidities rather than chronological age per se should be the decisive factors in making a decision about device implantation selection for survival and well-being benefit in elderly patients.
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- 2016
45. Comparing biologicals and small molecule drug therapies for chronic respiratory diseases: An EAACI Taskforce on Immunopharmacology position paper
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Cristiana Stellato, Leif Bjermer, Luigi Cari, Edward F. Knol, Francesca Levi-Schaffer, Frank A. Redegeld, Kian Fan Chung, Oscar Palomares, Ibon Eguiluz-Gracia, Zuzana Diamant, Ian M. Adcock, Franziska Roth-Walter, Cristina Benito-Villalvilla, Betty C.A.M. van Esch, Gaetano Caramori, Rodolfo Bianchini, Antonios G.A. Kolios, Pier Giorgio Puzzovio, Giuseppe Nocentini, University of Zurich, and Stellato, Cristiana
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0301 basic medicine ,Allergy ,Respiratory Tract Diseases ,Pulmonary Disease, Chronic Obstructive ,DOUBLE-BLIND ,0302 clinical medicine ,Eosinophilic ,Immunology and Allergy ,antibodies ,Molecular Targeted Therapy ,Pharmaceutical sciences ,Non-U.S. Gov't ,media_common ,COPD ,Research Support, Non-U.S. Gov't ,Disease Management ,INHIBITOR ,asthma ,biologicals ,chronic obstructive pulmonary disease ,small molecule drugs ,Phenotype ,Treatment Outcome ,2723 Immunology and Allergy ,Drug ,medicine.medical_specialty ,PROSTAGLANDIN D-2 ,media_common.quotation_subject ,Immunology ,INNATE LYMPHOID-CELLS ,610 Medicine & health ,CRTH2 ANTAGONIST ,Research Support ,OBSTRUCTIVE PULMONARY-DISEASE ,Diagnosis, Differential ,03 medical and health sciences ,Journal Article ,medicine ,Humans ,Intensive care medicine ,Asthma ,CLUSTER-ANALYSIS ,2403 Immunology ,Biological Products ,business.industry ,medicine.disease ,Immunopharmacology ,030104 developmental biology ,030228 respiratory system ,ANTIBODY ,Chronic Disease ,10033 Clinic for Immunology ,Position paper ,Antibodies, Asthma, Biologicals, Chronic Obstructive Pulmonary Disease, Small Molecule Drugs, Immunology and Allerg, Immunology ,business ,Biomarkers - Abstract
Chronic airway diseases such as asthma and chronic obstructive pulmonary disease (COPD), together with their comorbidities, bear a significant burden on public health. Increased appreciation of molecular networks underlying inflammatory airway disease needs to be translated into new therapies for distinct phenotypes not controlled by current treatment regimens. On the other hand, development of new safe and effective therapies for such respiratory diseases is an arduous and expensive process. Antibody-based (biological) therapies are successful in treating certain respiratory conditions not controlled by standard therapies such as severe allergic and refractory eosinophilic severe asthma, while in other inflammatory respiratory diseases, such as COPD, biologicals are having a more limited impact. Small molecule drug (SMD)-based therapies represent an active field in pharmaceutical research and development. SMDs expand biologicals' therapeutic targets by reaching the intracellular compartment by delivery as either an oral or topically based formulation, offering both convenience and lower costs. Aim of this review was to compare and contrast the distinct pharmacological properties and clinical applications of SMDs- and antibody-based treatment strategies, their limitations and challenges, in order to highlight how they should be integrated for their optimal utilization and to fill the critical gaps in current treatment for these chronic inflammatory respiratory diseases.
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- 2019
46. Addressing and proposing solutions for unmet clinical needs in the management of myeloproliferative neoplasm-associated thrombosis: A consensus-based position paper
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Ida Martinelli, Valerio De Stefano, Guido Finazzi, Giovanni Barosi, Anna Falanga, Francesco Rodeghiero, Alessandro M. Vannucchi, Tiziano Barbui, Barbui, T, De Stefano, V, Falanga, A, Finazzi, G, Martinelli, I, Rodeghiero, F, Vannucchi, A, and Barosi, G
- Subjects
medicine.medical_specialty ,Consensus ,Delphi Technique ,Gene mutation ,lcsh:RC254-282 ,Article ,Myeloproliferative neoplasms ,Myeloproliferative disease ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Disease management (health) ,Intensive care medicine ,Thrombosis, Neoplasms, Delphi Technique, Essential Thrombocythemia, Polycythemia Vera, Risk Management, Anticoagulants, Aspirin, Veins ,Myeloproliferative neoplasm ,Risk management ,Randomized Controlled Trials as Topic ,Health Services Needs and Demand ,Myeloproliferative Disorders ,business.industry ,Essential thrombocythemia ,Anticoagulants ,Disease Management ,Thrombosis ,Hematology ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Settore MED/15 - MALATTIE DEL SANGUE ,Risk factors ,Oncology ,Splanchnic vein thrombosis ,030220 oncology & carcinogenesis ,Position paper ,business ,030215 immunology - Abstract
This article presents the results of a group discussion among an ad hoc constituted Panel of experts aimed at highlighting unmet clinical needs (UCNs) in the management of thrombotic risk and thrombotic events associated with Philadelphia-negative myeloproliferative neoplasms (Ph-neg MPNs). With the Delphi technique, the challenges in Ph-neg MPN-associated thrombosis were selected. The most clinically relevant UCNs resulted in: (1) providing evidence of the benefits and risks of direct oral anticoagulants, (2) providing evidence of the benefits and risks of cytoreduction in patients with splanchnic vein thrombosis without hypercythemia, (3) improving knowledge of the role of the mutated endothelium in the pathogenesis of thrombosis, (4) improving aspirin dosing regimens in essential thrombocythemia, (5) improving antithrombotic management of Ph-neg MPN-associated pregnancy, (6) providing evidence for the optimal duration of anticoagulation for prophylaxis of recurrent VTE, (7) improving knowledge of the association between somatic gene mutations and risk factors for thrombosis, and (8) improving the grading system of thrombosis risk in polycythemia vera. For each of these issues, proposals for advancement in research and clinical practice were addressed. Hopefully, this comprehensive overview will serve to inform the design and implementation of new studies in the field.
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- 2019
47. Treatment of mantle cell lymphoma in Asia: a consensus paper from the Asian Lymphoma Study Group
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Seok Jin Kim, Dok Hyun Yoon, Deok Hwan Yang, Bing Xu, Koji Izutsu, Lim Soon Thye, Tong Yu Lin, Junning Cao, Tsai Yun Chen, Won Seog Kim, and Yok-Lam Kwong
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,Asia ,medicine.medical_treatment ,Antineoplastic Agents ,Review ,Lymphoma, Mantle-Cell ,Hematopoietic stem cell transplantation ,Disease ,Guidelines ,lcsh:RC254-282 ,chemistry.chemical_compound ,Maintenance therapy ,Chemoimmunotherapy ,Internal medicine ,medicine ,Humans ,Molecular Biology ,Mantle cell lymphoma ,business.industry ,lcsh:RC633-647.5 ,Hematopoietic Stem Cell Transplantation ,Disease Management ,Hematology ,lcsh:Diseases of the blood and blood-forming organs ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Lymphoma ,Radiation therapy ,Treatment ,chemistry ,Ibrutinib ,Immunotherapy ,business - Abstract
Background Mantle cell lymphoma (MCL) is a B cell malignancy that can be aggressive and with a poor prognosis; the clinical course is heterogeneous. The epidemiology of MCL in Asia is not well documented but appears to comprise 2–6% of all lymphoma cases based on available data, with variation observed between countries. Although international guidelines are available for the treatment of MCL, there is a lack of published data or guidance on the clinical characteristics and management of MCL in patient populations from Asia. This paper aims to review the available treatment and, where clinical gaps exist, provide expert consensus from the Asian Lymphoma Study Group (ALSG) on appropriate MCL management in Asia. Body Management strategies for MCL are patient- and disease stage-specific and aim to achieve balance between efficacy outcomes and toxicity. For asymptomatic patients with clearly indolent disease, observation may be an appropriate strategy. For stage I/II disease, following international guidelines is appropriate, which include either a short course of conventional chemotherapy followed by consolidated radiotherapy, less aggressive chemotherapy regimens, or a combination of these approaches. For advanced disease, the approach is based on the age and fitness of the patient. For young, fit patients, the current practice for induction therapy differs across Asia, with cytarabine having an important role in this setting. Hematopoietic stem cell transplantation (HSCT) may be justified in selected patients because of the high relapse risk. In elderly patients, specific chemoimmunotherapy regimens available in each country/region are a treatment option. For maintenance therapy after first-line treatment, the choice of approach should be individualized, with cost being an important consideration within Asia. For relapsed/refractory disease, ibrutinib should be considered as well as other follow-on compounds, if available. Conclusion Asian patient-specific data for the treatment of MCL are lacking, and the availability of treatment options differs between country/region within Asia. Therefore, there is no clear one-size-fits-all approach and further investigation on the most appropriate sequence of treatment that should be considered for this heterogeneous disease.
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- 2020
48. British Lymphology Society's position paper for management of people with lymphoedema in presence of deep vein thrombosis: a summary.
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O'Neill, Catriona and Elwell, Rebecca
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LYMPHEDEMA treatment , *PULMONARY embolism , *VENOUS thrombosis , *MEDICAL protocols , *COMPRESSION therapy , *PROFESSIONAL associations , *PATIENT education , *DISEASE management , *POSTTHROMBOTIC syndrome , *DISEASE risk factors , *SYMPTOMS , *DISEASE complications - Abstract
There is some confusion surrounding the management of people with lymphoedema in the presence of deep vein thrombosis (DVT). This may be in relation to the suitability of commencing compression therapy or regarding the continuation of compression therapy in those who develop DVT. The purpose of this British Lymphology Society position paper is to support evidence-based practice and debunk the myths surrounding the management of DVT and lymphoedema. [ABSTRACT FROM AUTHOR]
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- 2022
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- View/download PDF
49. Infectious Diseases Society of America Position Paper: Recommended Revisions to the National Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) Sepsis Quality Measure.
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Rhee, Chanu, Chiotos, Kathleen, Cosgrove, Sara E, Heil, Emily L, Kadri, Sameer S, Kalil, Andre C, Gilbert, David N, Masur, Henry, Septimus, Edward J, Sweeney, Daniel A, Strich, Jeffrey R, Winslow, Dean L, and Klompas, Michael
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ANTIBIOTICS , *COMMUNICABLE diseases , *MEDICAL quality control , *MEDICAL protocols , *MEDICAL prescriptions , *PROFESSIONAL associations , *SEPTIC shock , *SEPSIS , *EVIDENCE-based medicine , *DISEASE management , *PROFESSIONAL practice , *DISEASE progression , *EARLY medical intervention - Abstract
The Centers for Medicare & Medicaid Services' Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) measure has appropriately established sepsis as a national priority. However, the Infectious Diseases Society of America (IDSA and five additional endorsing societies) is concerned about SEP-1's potential to drive antibiotic overuse because it does not account for the high rate of sepsis overdiagnosis and encourages aggressive antibiotics for all patients with possible sepsis, regardless of the certainty of diagnosis or severity of illness. IDSA is also concerned that SEP-1's complex "time zero" definition is not evidence-based and is prone to inter-observer variation. In this position paper, IDSA outlines several recommendations aimed at reducing the risk of unintended consequences of SEP-1 while maintaining focus on its evidence-based elements. IDSA's core recommendation is to limit SEP-1 to septic shock, for which the evidence supporting the benefit of immediate antibiotics is greatest. Prompt empiric antibiotics are often appropriate for suspected sepsis without shock, but IDSA believes there is too much heterogeneity and difficulty defining this population, uncertainty about the presence of infection, and insufficient data on the necessity of immediate antibiotics to support a mandatory treatment standard for all patients in this category. IDSA believes guidance on managing possible sepsis without shock is more appropriate for guidelines that can delineate the strengths and limitations of supporting evidence and allow clinicians discretion in applying specific recommendations to individual patients. Removing sepsis without shock from SEP-1 will mitigate the risk of unnecessary antibiotic prescribing for noninfectious syndromes, simplify data abstraction, increase measure reliability, and focus attention on the population most likely to benefit from immediate empiric broad-spectrum antibiotics. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
50. Health-Related Quality of Life and Treatment of Older Adults with Acute Myeloid Leukemia: a Young International Society of Geriatric Oncology Review Paper
- Author
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Kah Poh Loh, Saurabh Dahiya, Anita J. Kumar, Maya Abdallah, Nina Rosa Neuendorff, and Heidi D. Klepin
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Gerontology ,Cancer Research ,Clinical Decision-Making ,Article ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Surveys and Questionnaires ,hemic and lymphatic diseases ,Humans ,Medicine ,Geriatric Assessment ,Aged ,Aged, 80 and over ,Health related quality of life ,Clinical Trials as Topic ,business.industry ,Age Factors ,Disease Management ,Myeloid leukemia ,Geriatric assessment ,Hematology ,Combined Modality Therapy ,Therapeutic trial ,humanities ,Leukemia, Myeloid, Acute ,Treatment Outcome ,Oncology ,Geriatric oncology ,Health Care Surveys ,030220 oncology & carcinogenesis ,Quality of Life ,Observational study ,business ,030215 immunology ,Cohort study - Abstract
PURPOSE OF REVIEW: The treatment landscape for older patients with acute myeloid leukemia (AML) is evolving. Many treatments have comparable efficacy making their impact on quality of life (QoL) an important differentiating factor. In this review, we discuss QoL in older adults with AML, focusing on therapeutic and observational trials that have incorporated QoL assessments. FINDINGS: Health-related quality of life (HRQoL) is a multi-dimensional concept incorporating physical, mental, emotional, and social functioning domains. HRQoL components overlap with components of geriatric assessment, a multidisciplinary diagnostic process that identifies underlying vulnerabilities of older adults and guides subsequent management strategies. HRQoL questionnaires may be general, cancer-specific, leukemia-specific, or symptom-focused. Therapeutic and observational cohort studies suggest HRQoL improves, or at least remains stable, during intensive and lower intensity therapies. Nonetheless, HRQoL is not routinely incorporated in AML therapeutic trials. SUMMARY: HRQoL assessments can inform both decision-making and management for older adults with AML.
- Published
- 2019
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