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Healing by Secondary Intention

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182. How to improve the Organisation of Mental healthcare for older adults in Belgium?

of Mental healthcare for older adults in Belgium? 17 severe psychiatric disorders). The intention was to develop a specific care circuit and care network for each of these groups in order to promote specialization, trans-mural care and to increase the capacity for chronic psychiatric care. Moreover, several semi-ambulatory structures, were set up, such as day centres, day hospitalisation and night hospitals. The numeric result of the reconversion operation was quite successful and led to increase

2018 Belgian Health Care Knowledge Centre

183. Interventions for managing medication-related osteonecrosis of the jaw. (PubMed)

trials and add them to CENTRAL.We included randomised controlled trials (RCTs) comparing one modality of intervention with another for the prevention or treatment of MRONJ. For 'prophylaxis of MRONJ', the primary outcome of interest was the incidence of MRONJ; secondary outcomes were QoL, time-to-event, and rate of complications and side effects of the intervention. For 'treatment of established MRONJ', the primary outcome of interest was healing of MRONJ; secondary outcomes were QoL, recurrence (...) 0.08, 95% CI 0.00 to 1.51; 176 participants; very low-quality evidence). Secondary outcomes were not reported. In another trial comparing wound closure by primary intention with wound closure by secondary intention after dental extractions in people treated with oral bisphosphonates (700 participants), no cases of intraoperative complications or postoperative MRONJ were observed. QoL was not investigated. Treatment of MRONJOne trial analysed hyperbaric oxygen (HBO) treatment used in addition

2017 Cochrane

185. Management of nonobstructive azoospermia: a committee opinion

harvest and reduced sequelae including hypogonadism. Serum testosterone levels do fall acutely after TESE but return to 95% of baseline after healing is complete (55, 56). TIMINGOFSPERMRETRIEVAL AnotherimportantconsiderationinthemanagementofNOA is the timing of sperm retrieval. Surgical sperm retrieval can be performed during an IVF cycle to coincide with oocyte retrieval with the intent of using fresh sperm, if identi?ed, for ICSI. Alternatively, sperm retrieval can be performed (...) are variable within the United States. In some cen- ters, procedures for sperm retrieval are coordinated with oocyte retrieval so that fresh sperm are used for ICSI. In contrast, other centers offer sperm retrieval with cryopreservation with the intention of using thawed sperm at a later date. Finally, the methods used for sperm retrieval in men with NOA are variable. GOALSOFMANAGEMENT FORMENWITHNOA Men with NOA are entitled to a diagnostic evaluation that targets identi?cation of treatable, genetically

2018 Society for Assisted Reproductive Technology

186. Regorafenib (Stivarga) indicated as monotherapy for the treatment of adult patients with hepatocellular carcinoma (HCC) who have been previously treated with sorafenib treatment

endpoint: OS Secondary: PFS, ORR, QoL, safety Yes Abbreviations: BSC=best supportive care; ORR=overall response rate; OS=overall survival; PFS=progression-free survival; QoL=quality of life. Sources: clinical study report and MAH submission file. 2.8 Deviations from project plan D0011, D0016 and D0017 were initially selected as relevant research questions in the project plan. During the assessment phase, however, the authors decided that these questions were not informa- tive and decided not to include

2018 EUnetHTA

187. Continuous glucose monitoring (CGM real-time) and flash glucose monitoring (FGM) as personal, standalone systems in patients with diabetes mellitus treated with insulin

protein, and assessment of feet for signs of neuropathy. • Standard criteria for referral of patients from primary care to secondary or tertiary care. Continuous (real-time) and flash glucose monitoring as personal, standalone systems in patients with DM treated with insulin Version 1.4, 27 July 2018 EUnetHTA Joint Action 3 WP4 87 For the proper management of diabetes, achieving optimal glycaemic control while avoiding hy- poglycaemia is essential. In accordance with the national standards (...) Action 3 WP4 89 FreeStyle Libre ® should be available for patients either through specialist/secondary care or primary care as per local pathway approvals. Also, real-time transmission of data should be considered in children who need alarms and in non-autonomous or isolated patients, which raises the issue of care organization geared towards telemedicine. Medtronic submission file [68] The target population for Guardian™ Connect personal standalone CGM is patients with type 1 diabetes of all ages

2018 EUnetHTA

188. A Noncultured Autologous Skin Cell Spray Graft for the Treatment of Burns

= 13). 22 The study compared the use of BIOBRANE synthetic wound dressing with or without ReCell to the standard of care (INTRASITE, ACTICOAT, and DuoDERM dressings applied every two to three days). 22 The primary end point was whether or not early intervention with BIOBRANE with or without ReCell reduced the incidence of surgery at day 10. Secondary outcomes of interest included the rate of healing, scar appearance, pain, number of dressing changes and analgesic use, and costs. The first (...) and the donor sites), as well as the aesthetic and functional quality of healing (i.e., pigmentation, joint contractures). Secondary end points included adverse effects, postoperative pain and medication use, donor skin requirements, and the length of time to complete the procedure. A 2017 conference presentation described a multi-centre, randomized controlled trial that compared ReCell to MSTSG with a 2:1 expansion ratio for the treatment of deep partial-thickness burn injuries (n = 101). 9 The primary end

2018 CADTH - Issues in Emerging Health Technologies

189. Management of Diabetic Foot

http://www.acadmed.org.my http://www.moa-home.com http://www.mems.my http://fms-malaysia.org https://marp.online Also available as an app for Android and IOS platform: MyMaHTAS STATEMENT OF INTENT These clinical practice guidelines (CPG) are meant to be guides for clinical practice, based on the best available evidence at the time of development. Adherence to these guidelines may not necessarily guarantee the best outcome in every case. Every healthcare provider is responsible for the management (...) of Diabetic Foot (Second Edition) d. Treatment • Appropriate analgesia should be considered in painful diabetic foot. • Antibiotics should be used as an adjunct to surgical debridement in infected diabetic foot. • Advanced wound dressings may be offered in diabetic foot ulcer. • Adjuvant therapy may be offered in delayed wound healing in diabetic foot with good vascularity. • Revascularisation should be offered in diabetic patients with peripheral arterial disease. • Surgical debridement by trained

2018 Ministry of Health, Malaysia

190. Heart Failure

for heart failure. Weak FOR Moderate CRT should be considered in patients who have pre-existing right ventricular pacing who develop symptoms of heart failure with an LVEF of less than 35%, to decrease hospitalisation for heart failure. Weak FOR Low CRT is contraindicated in patients with QRS duration of less than 130 ms, because of lack of efficacy and possible harm. Strong AGAINST Moderate Implantable cardioverter defibrillators An ICD should be considered as a secondary prevention indication (...) from the previous expert panel involved in earlier editions of the guidelines, together with advice from the NHFA internal clinical advisory committees, members were approached to be in the working group, according to expertise. Based on the determined scope, guideline writing groups were established to cover the following four topics: diagnosis, drugs, devices, and non-pharmacological management. For each writing group, a primary and secondary writer were appointed by group consensus, on the basis

2018 Cardiac Society of Australia and New Zealand

191. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions

clinicians, academic instructors, clinical instructors, students, interns, residents, and fellows regarding the best current practice of orthopaedic physical therapy Statement of Intent These guidelines are not intended to be construed or to serve as a standard of medical care. Standards of care are determined on the basis of all clinical data available for an individual patient and are subject to change as scientific knowledge and technology advance and patterns of care evolve. These parameters (...) meniscectomy or second ACL injury. Pathoanatomical Features 2010 Summary Meniscus The medial and lateral menisci cover the superior aspect of the tibia. Each meniscus is composed of fibrocartilage and is wedge shaped. The lateral meniscus is more circular, whereas the medial meniscus is more crescent shaped. The lateral meniscus is more mobile than the medial meniscus. The menisci function to distribute stress across the knee during weight bearing, provide shock absorption, serve as secondary joint

2018 American Physical Therapy Association

192. Breastfeeding - Promoting and Supporting the Initiation, Exclusivity, and Continuation of Breastfeeding in Newborns, Infants and Young Children

healthy outcomes for newborns and infants. ? The practice of breastfeeding extends beyond physiology to include other components, such as social, political, economic, cultural, psychosocial, and organizational factors. These factors can positively or negatively affect breastfeeding intention, initiation, exclusivity, and continuation. ? Breastfeeding supports the parental relationship with the newborn, infant, and young child, including bonding and attachment. ? Breastfeeding persons have the right (...) practitioners. The secondary audience of the practice recommendations are peers who support and promote breastfeeding either independently or in collaboration with nurses and the interprofessional team. 11 BEST PRACTICE GUIDELINES • www.RNAO.ca BACKGROUND Breastfeeding - Promoting and Supporting the Initiation, Exclusivity, and Continuation of Breastfeeding for Newborns, Infants, and Y oung Children ? Education recommendations G are directed to those responsible for the education of nurses

2018 Registered Nurses' Association of Ontario

193. Implementing Supervised Injection Services

, and research positions in a range of health-care organizations, practice areas, and academic settings. These experts work with people who inject drugs who are receiving services and supports in a wide range of health-care settings (e.g., SIS, community health centres, harm reduction programs, public health, and primary health care) or represent other sectors (such as post-secondary institutions and professional unions). To determine the purpose and scope of this Guideline, the RNAO Best Practice Guideline (...) and Preferences” denotes the prioritization of approaches that facilitate health equity and the importance of consideration for desired care. Content for “Benefits and Harms” and “Values and Preferences” may or may not include research from the systematic review. When applicable, the RNAO expert panel contributed to these areas. Concepts Used in This Guideline Health workers: defined as “all people engaged in actions whose primary intent is to enhance health” (1). This includes both regulated health

2018 Registered Nurses' Association of Ontario

194. Guidelines of care for the management of cutaneous squamous cell carcinoma

approach was used and available evidence was obtained by using a systematic search and review of published studies from PubMed and the Cochrane Library databases from January 1960 through April 2015 for all identified clinical questions. A secondary search was subsequently undertaken to identify and review published studies from April 2015 to August 2016 to provide the most current information. Searches were prospectively limited to publications in the English language. As cSCC is traditionally known

2018 American Academy of Dermatology

196. Shingrix vaccine for herpes zoster

may be preceded by prodromal pain or itching, after which erythematous macules or papules appear. These progress into vesicular lesions, then into pustules. The pustules typically crust over within the course of about ten days. In many patients, the HZ rash heals and painful symptoms resolve entirely within about four weeks. 6 In up to about thirty percent of patients, however, the pain will persist for months beyond the initial rash, known as postherpetic neuralgia (PHN). 3 PHN is conventionally (...) publications was the “modified Total Vaccinated Cohort” (mTVC). This cohort excluded patients who did not receive their second study vaccine dose (due to withdrawal or having a HZ episode), or patients who had a HZ episode =1 month after receiving their second study vaccine. The “total vaccinated cohort” (TVC), including every patient who received a study vaccine, was the population used for all safety analysis (most akin with intention-to-treat analysis). A sensitivity analysis was performed using the TVC

2018 Therapeutics Letter

197. Atherosclerotic Cardiovascular Disease in South Asians in the United States: Epidemiology, Risk Factors, and Treatments: A Scientific Statement From the American Heart Association

by Asian American subgroups and sex compared with non-Hispanic whites. Loess smoothing curves represent PMRs by age (≥45 years) and ethnicity for all CVD and cerebrovascular disease. NCHS indicates National Center for Health Statistics. Reprinted from Jose et al with permission from the American College of Cardiology Foundation. Copyright © 2014, the American College of Cardiology Foundation. The success of primary and secondary CVD prevention guidelines provided by the American Heart Association (AHA (...) of expertise on South Asians and CVD. A general framework outlined by the committee chairs was used to conduct a comprehensive literature review to summarize existing evidence, to indicate gaps in current knowledge, and to formulate recommendations. Only English-language studies were reviewed, with PubMed/MEDLINE as our primary resource, as well as the Cochrane Library Reviews, Centers for Disease Control and Prevention, and US Census data as secondary resources. Inductive methods and descriptive studies

2018 American Heart Association

198. Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review

, and family relationships; it is the leading cause of disability and is often refractory to treatment. 1,2 Chronic pain is often defined as pain lasting 3 months or longer or persisting past the normal time for tissue healing, though definitions vary. 1,3 Chronic pain affects millions of adults in the United States, with an annual cost in personal and health system expenditures conservatively estimated at $560 billion to $635 billion. 1 Chronic pain is multifaceted and is influenced by multiple factors

2018 Effective Health Care Program (AHRQ)

199. Management of Crohn's Disease in Adults

with Crohn’s disease. These guidelines are established for clinical practice with the intent of suggesting preferable approaches to particular medical problems as established by interpretation and collation of scienti? cally valid research, derived from extensive review of published literature. When exercising clinical judgment, health-care providers should incorporate this guideline along with patient’s needs, desires, and their values in order to fully and appropriately care for patients with Crohn’s (...) of remission and achieving mucosal healing in patients with active Crohn’s disease and should not be used to treat patients with active Crohn’s disease (strong recommendation, moderate level of evidence). 12. Controlled ileal release budesonide at a dose of 9 mg once daily is effective and should be used for induction of symptomatic remission for patients with mild-to-moderate ileocecal Crohn’s disease (strong recommendation, low level of evidence). 13. Metronidazole is not more effective than placebo

2018 American College of Gastroenterology

200. Spine Surgery

is required. Unlike fusion, motion at the level of disc replacement is maintained, which would seem to be advantageous in terms of preventing secondary degenerative changes and preserving spine mechanics. This document addresses lumbar disc arthroplasty when performed as an elective, non-emergent procedure and not as part of the care of an acute or traumatic event. Definitions Conservative management should include a combination of strategies to reduce inflammation, alleviate pain, and improve function

2018 AIM Specialty Health

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